School Program Request | Fairfield Museum and History Center

School / Organization / Group Name(Required)

Street Address(Required)

City, State, & Zip Code(Required)

School / Organization / Group Type(Required)

Number of Students / Participants(Required)

Grade Level or Age Range(Required)

Contact Information

Main Contact First Name(Required)

Main Contact Last Name(Required)

Best Phone Number to Reach Main Contact(Required)

Main Contact Email(Required)

Program Request

Select a Program Type(Required)

At Fairfield Museum

At Your School / Organization

We can customize your program experience. Please select which experience you're looking for.(Required)

1-part program - Field Trip at Fairfield Museum (Up to 1.5 hr)- $8/student

2-part program - Field Trip at Fairfield Museum (Up to 2.5 hrs)- $10/student

3-part program - Field Trip at Fairfield Museum (Up to 3.5 hrs) - $12/student

Outreach Program at Your School / Organization - $8/student

Please tell us the topics & themes that you'd like to explore in the field trip or outreach program.

Program Date - First Choice(Required)

Please specify month, date, and year.

Program Date - Second Choice(Required)

Please specify month, date, and year.

Program Date - Third Choice

Please specify month, date, and year.

Estimated Arrival Time(Required)

Please allow enough travel time to arrive 15 minutes before your program.

Estimated Departure Time(Required)

Are you requesting space for lunch?(Required)

Yes

Please note that we do not have a cafeteria. We cannot guarantee a space for lunch, but will do our best to accommodate your group.

Are there any accessibility needs or additional information about your group? If so, please share so that we can best meet the needs of your students.

Financial Assistance Request

The Fairfield Museum is committed to offering opportunities for Title I schools through the generous support of funders and private donors. Waivers for program fees and funds for buses are available on a first come, first served basis. Schools must have at least 50% of their students receiving free/reduced lunch.

Do you request financial assistance for your school / organization / community group?(Required)

Yes

Please Note: The Fairfield Museum does not schedule buses or transportation. It is your group's responsibility to arrange for transportation to and from the Museum.

Program Follow-Up

Do you acknowledge that these dates are not confirmed until a Fairfield Museum staff member reaches out to you and sends a confirmation?(Required)

Yes

School / Organization / Group Program Request Form

Book a Special Experience for Your Students!

School Program Request Form

Contact Information

Program Request

Financial Assistance Request

Program Follow-Up

Book a Special Experience for Your Students!

School Program Request Form

Contact Information

Program Request

Financial Assistance Request

Program Follow-Up

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