Bridging the Watershed - Schedule a Field Study

Name *
Email *
School *
School Address *
School Address 2 *
School Phone Number *
Cell Phone Number
Good time to call if necessary
Number where you can be reached the day of the field study *
Bus Pick Up Time *	AM
Park Arrival Time *	AM
Park Departure Time *	PM
Bus Drop Off Time *	PM
Module of Interest *
Grade of Class *
Number of Students *
Subject
First Park Preference *
Second Park Preference
First Possible Visit Date *
Second Possible Visit Date *
Third Possible Visit Date
How do you prefer to do the BTW evaluation? *	Electronic (students must have access to the internet at school to take a pre and post survey online) Paper (hard copies of the pre and post surveys will be emailed to you to print out)
Concerns or Comments: Please let us know about any special accommodations you need.