var giftType = "One-time";
Virtual Field Trip Request
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1.
Question - Required -
Your First and Last Name:
*
2.
Question - Required -
Your Email Address:
*
3.
Question - Required -
School Name:
*
4.
Question - Required -
Is your school Title 1?
Please select response
Yes
No
*
5.
Question - Required -
School Zip Code
*
6.
Question - Required -
Grade Level
*
7.
Question - Required -
Students per Class:
*
8.
Question - Required -
Your Phone Number:
*
9.
Question - Required -
Please list 3 potential dates or a day of the week for scheduling your virtual visit.
*
10.
Question - Required -
Preferred Start Time:
11.
Question - Not Required -
Please provide any additional information that is important for us to know about your class or any topics you would like covered during the program.
Spam Control Text:
Please leave this field empty
