Shedd Aquarium - Chicago | Action | : Survey - Outreach Reservation Form

All outreach reservations must be made at least 21 days before your visit. Outreach programs are available Sept. 4, 2012, to June 7, 2013.

Please fill out the following to request an outreach program at your school.
Prefer to fax or mail a form? Download a pdf.

Outreach programs are available within a 60-mile radius of Shedd Aquarium.

1. Contact information:

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Name:

First Required	Last Required

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Email: Required

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

Remember me. What's this?

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Question - Required - 2. Name of school or group:

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Question - Required - 3. School address:

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Question - Required - 4. City:

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Question - Required - 5. State:

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Question - Required - 6. Zip Code:

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Question - Required - 7. School phone number:

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Question - Required - 8. School fax number:

Question - Not Required - 9. So that we can better serve your group, please check all that apply:

	Bilingual/ESL
	Special Learning Needs
	Other

Question - Not Required - 10. If other, please describe:

Select a date for our visit to you. Programs are offered Tuesdays only. Please list more than one choice as dates are subject to availability.

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Question - Required - 11. Date of program: 1st choice

Month

Day

Year

Question - Not Required - Program start time*

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Question - Required - 12. Date of program: 2nd choice

Month

Day

Year

Question - Not Required - Program start time*

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Question - Required - 13. Date of program: 3rd choice

Month

Day

Year

Question - Not Required - Program start time*

*If registering for more than one program, select a time for the first program only.

Take your class on a Shedd learning adventure. Large-group outreach programs are $255 each for 50 minutes. Presentations are suitable for groups of 100-250 students per program.

Schedule large-group outreach program(s):

Amazon: Raised on the River

Question - Not Required - 14. Number of Amazon: Raised on the River programs:

Question - Not Required - 15. Grade level(s) of students:

Question - Not Required - 16. Number of students per program:

Pacific Northwest: Mapping Out Mammals

Question - Not Required - 17. Number of Pacific Northwest: Mapping Out Mammals programs:

Question - Not Required - 18. Grade level(s) of students:

Question - Not Required - 19. Number of students per program:

Coral Reef: Feeding Frenzy

Question - Not Required - 20. Number of Coral Reef: Feeding Frenzy programs:

Question - Not Required - 21. Grade level(s) of students:

Question - Not Required - 22. Number of students per program:

Animal Extension

Question - Not Required - 23. Would you like to add an Animal Extension program for an additional $95 (up to 8 classrooms)?

Program Location
All programs must be presented in an indoor room with either a stage or at least 12' x 20' of open floor space.

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Question - Required - 24. Program will be located in:

Question - Not Required - 25. If other, please describe:

Mileage Fee
There is no mileage fee for schools within 20 miles of Shedd Aquarium. For schools farther away than 20 miles, a travel surcharge of $0.80 will be assessed for each mile over 20. The amount will be stated in your confirmation letter.

Requested dates and times are subject to availability. You will receive a confirmation letter when your reservation is booked. If you have questions about an existing reservation, please e-mail groupreservations@sheddaquarium.org and be sure to include your confirmation number.

Outreach Reservation Form - Large Groups