Request a Workshop at Your Site School Name * Contact Name * First Name Last Name School Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Extension Phone Number Type School Cell Contact Email * Number of Students * Groups with fewer students than the minimum will be charged for the minimum of 20 students for offsite programs. Grade Level * PreK Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 K-6 Number of Classrooms * Where will our educator be working? * We have a dedicated space that your educator can set up in all day, with our classes rotating in. We need you to move from classroom to classroom. Pre K + Kindergarten Our Pre K workshops are intended for students who will be starting kindergarten the following fall (4 and 5-year-olds). These workshops are not a good fit for children under 4 due to developing fine motor skills and small pieces that can be put in mouths. Please request these workshops ONLY for Pre K and kindergarten students. Thank you! 60-minute workshop/$11.50 per student Kindergarten - Grade 2 60-minute workshops/$11.50 per student 90-minute workshops/$13.50 per student Grades 3-6 60-minute workshops/$11.50 per student 90-minute workshops/$13.50 per student School-Age Care The following workshops work well for mixed-age groups K-5. 60-minute workshops/$11.50 per student 90-minute workshops/$13.50 per student Date Option 1 * Please type in your first choice date option. MM DD YYYY Date Option 2 Please type in your second choice date option. MM DD YYYY Date Option 3 Please type in your third choice date option. MM DD YYYY Photography Release Option * The Works Museum uses photography to display exhibits, events and workshops for marketing purposes in print publications and on the website. Please indicate whether you give permission for photographs of your group to be used by The Works Museum. If used in any of our print or electronic publications, students will never be identified by name or school. Yes No Questions or Comments Thank you!
