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Education Visit Request

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Last Name
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Phone Number
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Email
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City
City
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State
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Zip Code
Zip code
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Organization
Organization Name
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Event Date (First Choice)
Select a date
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Start Time (First Choice)
Include time for setup
Select a time
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End Time (First Choice)
The time you'd like the speaker to end
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Event Date (Second Choice)
If your first date choice is not available, indicate a second date that you'd like to request.
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Start Time (Second Choice)
Include time for setup
Select a time
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End Time (Second Choice)
The time you'd like the speaker to end
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Event Location Address
Your Address
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City
City
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State
  • - select a state -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
- select a state -
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Zip Code
Zip code
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Number of anticipated attendees
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Do you want the speaker to participate via live stream or in-person?(Required)
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What topic(s) would you like the Museum Educator to speak about?(Required)
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Please choose the category that best fits your organization(Required)
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Any other details or requests you'd like to make?
Ask us any questions...
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Payment & Cancellation(Required)
Payment will be processed only by invoice | Museum staff will provide the invoice | Invoice must be paid in full prior to event or the day of | Notice of cancellation must be provided a minimum of 24 hours' in advance | Request must be submitted a minimum of 4 weeks prior to event | Requests submitted less than 4 weeks prior cannot be guaranteed.
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