School Program Request | Fairfield Museum and History Center

School / Organization Name(Required)

Street Address(Required)

City, State, & Zip Code(Required)

School / Organization Phone Number(Required)

School / Organization Type(Required)

Which of the following best describes your group?

Number of Students / Participants(Required)

Grade Level or Age Range(Required)

Number of Classes

Contact Information

Main Contact First Name(Required)

Main Contact Last Name(Required)

Main Contact Cell Phone Number(Required)

Main Contact Email(Required)

Program Request

Select a Program Type(Required)

Virtual

At Museum

At Your School / Organization

Select a Program(Required)

Virtual School - Burning of Fairfield (Grades 5-8)

Virtual School - Creating a Community (Grades 3-5)

In Person School Program

Program Date - First Choice(Required)

Please Specify Month and Date

Program Date - Second Choice(Required)

Please Specify Month and Date

Third Date Choice

Please Specify Month and Date

Estimated Time of Arrival

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

Estimated Time of Departure

Are you requesting space for lunch?

Yes

Additional information about your group that will help us to meet your needs and expectations

Financial Assistance Request

The Fairfield Museum is committed to offering opportunities for schools in need through the generous support of funders and private donors. 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 group?

Yes

School Program Request Form

Bring Your Students to the Museum

School Program Request Form

Contact Information

Program Request

Financial Assistance Request

Bring Your Students to the Museum

School Program Request Form

Contact Information

Program Request

Financial Assistance Request

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