School Programs Reservation

	Program Descriptions
	Educational Activity Kits
	Pre-visit Information
	Reservations

Canada Agriculture Musuem - Educational Activity Kit

School Programs Reservation

To serve you better, there are now four ways to register:

1. By phone
Please call 613-991-3053

2. By fax
Please print and fill out this form and then fax it to "Education Services" 613-993-7923.

3. By mail
Please print and fill out this form and mail it to:

4. By E-mail (on-line form)
*required fields

Please complete one application for each group.

School Name*
School Board
School Address
City
Province
Postal Code
Tel*	(include area code)
FAX
Teacher's Name*

Requested Date of Visit
1st Choice (Day/ Month/Year)	AM	PM
2nd Choice (Day/ Month/Year)	AM	PM

Estimated time of Arrival/Departure
Estimated time of Arrival
Estimated time of Departure

Program Choices (Please list your preference and two alternate choices)
1st
and or
2nd
and or
3rd

Total number of programs for this group:
Grade
Number of Students (maximum of 25 except for Bread Programs - maximum of 20)		Number of Chaperones
Language of Program		English French

Special Needs
Physically Challenged	yes	no	Developmentally Challenged	yes	no
ESL	yes	no	FSL	yes	no

Method of Payment
Cash Cheque Debit Card Credit Card (Visa/Master Card)
Please contact me as soon as possible regarding this matter.
Your E-mail address*

School Program Fees

Students: $6, $7, or $10 per student depending on program

Accompanying Adults: $1 per adult (excluding teachers)

Due to space limitations, we cannot guarantee programs.
Please complete one application for each group.
Confirmation of your scheduled program will be mailed to you.

Caution Allergens may be present throughout the Museum's indoor and outdoor facilities.