Mobile Field Trip Inquiry
Contact Name
Job Title
Contact Phone
Contact E-mail
Lead Teacher Name
Lead Teacher E-mail
Principal Name
Principal E-mail
School/Organization Name
School/Organization County
School/Organization Address
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
St Kitts & Nevis
St Lucia
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Other
Number of Classes
Additional classes are only $200.
Projected number of students served
Grade Level(s) served
Desired Mobile Field Trip Date
Mobile Field Trips generally last 120 minutes, with an additional 30 minutes for prep and 30 minutes for cleanup.
Desired Start Time
Desired End Time
Which theme would you like to explore for your Mobile Field Trip?
1st Choice
African American Art
Ceramics
Fiber
Folk Art
Native American Art
Printmaking
Traditional Craft
2nd Choice
African American Art
Ceramics
Fiber
Folk Art
Native American Art
Printmaking
Traditional Craft
3rd Choice
African American Art
Ceramics
Fiber
Folk Art
Native American Art
Printmaking
Traditional Craft
Who will be present in the room while artist works with the students?
Teacher
Administrator
Instructional Assistant
No one
Does KMAC Museum have permission to take pictures of students for promotional use? (Your answer has no impact on your request.)
Yes
No
Unsure
Any additional information we should know?
Payment Type
This is for reference. Payment will not be made until you are contacted by a KMAC educator in 2-3 days.
5x5
Delta Dental
Credit Card
Check
Other
How did you hear about KMAC Mobile Field Trips?
If you do not receive an e-mail notifying you that your submission has been received within 24 hours, please submit this form again or contact KMAC directly if technical problems persist.
Your reservation is not confirmed until your request is approved and you receive a confirmation e-mail from KMAC Education staff within 7 business days.
Register
