Shedd Aquarium - Chicago | Action | : Survey - Field Trip Reservation Request Form 9-12: Illinois Schools

All field trip reservation requests must be made at least 30 days before your visit. Requested dates and times are subject to availability. Programs are available Sept. 4, 2012 to June 7, 2013.

Please fill out the following to request a focused field trip with programs for grades 9-12.
Prefer to fax or mail a form? Download a pdf.

Optional student programs at Shedd are $125 each and offered Mondays and Wednesdays for up to 30 students per program.

1.

Contact information:

*

Name:

First Required	Last Required

*

Email: Required

Yes, I would like to receive e-mail from Shedd Aquarium

Remember me. What's this?

*2.

Question - Required - Name of school or group:

*3.

Question - Required - School address:

*4.

Question - Required - City:

*5.

Question - Required - State:

*6.

Question - Required - Zip Code:

*7.

Question - Required - School phone number:

*8.

Question - Required - School fax number:

Please reference the chart below to see field trip exhibit fees.

Field Trip 2012 - In-state 090712

*9.

Question - Required - Please choose your group visit options (Abbott Oceanarium show available based on availability):

*10.

Question - Required - I would like to add the Jellies special exhibit for $3.00 per person. (Please note to add Jellies to your visit, the Abbott Oceanarium is required.)

**Jellies is free for Illinois schools if booked from Oct. 1, 2012 - Feb. 28, 2013. Based on availability.

*11.

Question - Required - I would like to add a 4-D Experience for $3.50 per person

12.

Question - Not Required - If you've added a 4-D Experience, please select your preferred movie.

*13.

Question - Required - Total number of students:

*14.

Question - Required - Number of chaperones:

*15.

Question - Required - Grade(s) of classes:

*16.

Question - Required - Is your school in Illinois or out-of-state?

*17.

Question - Required - Do more than 50% of students at your school receive free or reduced lunch?

*18.

Question - Required - Date of visit: 1st choice

Month

Day

Year

*19.

Question - Required - Time of arrival:

*20.

Question - Required - Time of departure:

*21.

Question - Required - Date of visit: 2nd choice

Month

Day

Year

*22.

Question - Required - Time of arrival:

*23.

Question - Required - Time of departure:

*24.

Question - Required - Date of visit: 3rd choice

Month

Day

Year

*25.

Question - Required - Time of arrival:

*26.

Question - Required - Time of departure:

*27.

Question - Required - Do you need a lunch space? (Reservations based on availability)

28.

Question - Not Required - So that we can better serve your group, please check all that apply:

	Bilingual/ESL
	Special Learning Needs
	Other

29.

Question - Not Required - If other, please describe:

Take your class on a Shedd learning adventure. Optional student programs at Shedd are $125 each and offered Mondays and Wednesdays for up to 30 students per program.

Add grade 9-12 student programs to your field trip visit:

Exploring Pathology: Fish Dissection

30.

Question - Not Required - Number of Exploring Pathology programs:

31.

Question - Not Required - Grade level of students:

32.

Question - Not Required - Total number of students:

Mission Marine Habitat

33.

Question - Not Required - Number of Mission Marine Habitat programs:

34.

Question - Not Required - Grade level of students:

35.

Question - Not Required - Total number of students:

Great Lakes: Testing the Waters

36.

Question - Not Required - Number of Great Lakes: Testing the Waters programs:

37.

Question - Not Required - Grade level of students:

38.

Question - Not Required - Total number of students:

Lakeshore Biology

39.

Question - Not Required - Number of Lakeshore Biology programs:

40.

Question - Not Required - Grade level of students:

41.

Question - Not Required - Total number of students:

Requested dates and times are subject to availability and processed within 10 days. We will mail you a confirmation letter with payment options when your field trip request is booked. Please e-mail groupreservations@sheddaquarium.org if you have any questions.