Museums at Union Station Virtual Field Trip Request

2. School Name*

4. School Type*
   -- Select One --Ogden SchoolPublic SchoolPrivate/Charter SchoolHomeschoolDaycare/PreschoolChurch GroupInternationalAfter School / Youth ProgramSocial / Community Org.Other

6. School Address*

8. City*

9. State*

10. Zip Code*

12. School Phone Number*

16. About Your Group

18. Primary Contact First and Last Name*

20. Primary Contact's Cell Phone Number*

22. Primary Contact's Email Address*

24. Student Grade Level*

    1. Pre-K
    2. Kindergarten
    3. 1st Grade
    4. 2nd Grade
    5. 3rd Grade
    6. 4th Grade
    7. 5th Grade

    1. 6th Grade
    2. 7th Grade
    3. 8th Grade
    4. 9th Grade
    5. 10th Grade
    6. 11th Grade
    7. 12th Grade

26. Total Number of Students*

28. How many programs are you requesting? Each program may be booked for a maximum of 35 students.

    1. 1 program for 5-35 students
    2. 2 programs for 36-70 students
    3. 3 programs for 71-105 students
    4. Other

30. Please select which program you are reserving

    Only fill out if you selected 1 program for 5-35 students.

    1. Activist Ogden
    2. Women's Suffrage and Voting Rights Now
    3. Getting Around: Transportation in Ogden Then and Now
    4. T is for Train (recommended for Pre-K and Kindergarten groups)
32. If you are booking different programs for multiple classes, which programs are you requesting for each class?

    ONLY FILL OUT IF YOU'VE SELECTED 2 or MORE PROGRAMS (ex. Class 1: T is for Trains; Class 2: Activist Ogden: The Movement for Black Lives; Class 3: Activist Ogden: Civil Rights Movement; Class 4: Women's Suffrage and Voting Rights)

34. Do you prefer a 45 or 60 minute program?

    1. 45 minutes
    2. 60 minutes

38. Please list between 3 -5 possible dates and time when your class is available.
    Programs can be up to 60 minutes, Monday – Friday, starting at 9:30, 11:00 am and 1:00 pm.

    Programs can be up to 60 minutes, Monday – Friday, starting at 9:30, 11:00 am and 1:00 pm.

40. 1st Choice Date
    1st Choice Date

    1st Choice Date

42. 2nd Choice Date
    2nd Choice Date

    2nd Choice Date

44. 3rd Choice
    3rd Choice

    3rd Choice

46. 4th Choice
    4th Choice

    4th Choice

48. 5th Choice
    5th Choice

    5th Choice

50. I understand that all program participants – teacher and students – will need to use Zoom to participate in this virtual program.

    1. Yes
    2. I will need to use a different platform

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field