"*" indicates required fieldsName* First Name* Last Phone*Email* School Name*School Phone*Address* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Teachers*Number of Chaperones*Number of Classes*Any Special Needs Or AccommodationsVisit Date – First Choice* MM slash DD slash YYYY Arrival Time* Hours: Minutes AMPM AM/PMDeparture Time Hours: Minutes AMPM AM/PMVisit Date – Second Choice MM slash DD slash YYYY Arrival Time Hours: Minutes AMPM AM/PMDeparture Time Hours: Minutes AMPM AM/PMVisit Date – Third Choice MM slash DD slash YYYY Arrival Time Hours: Minutes AMPM AM/PMDeparture Time Hours: Minutes AMPM AM/PMProgram SelectionIsland Farm School trips offer school groups the choice of programs and recommends one program per group of ten students, with a minimum of three programs. Please follow this rule of thumb when selecting programs.Learning Level*Select your group's learning levelKindergarten – SecondThird- SeventhEighth- TwelfthMixed GradesNumber of StudentsNumber of StudentsPreferred Programs (choose at least 3)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash DayPreferred Programs (choose at least 4)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash DayPreferred Programs (choose at least 5)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash DayPreferred Programs (choose at least 6)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash DayPreferred Programs (choose at least 3)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryPreferred Programs (choose at least 4)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryPreferred Programs (choose at least 5)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryPreferred Programs (choose at least 6)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryPreferred Programs (choose at least 7)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryPreferred Programs (choose at least 8)* Home: Then & Now Hearth Cooking Blacksmith Shop Animals on the Farm 19th Century Toys & Games Wash Day Candles: From Liquid to Solid Farmers, Fishers & Fowlers Domestic Medicine Life on the Farm Journal Entry Computation in the CemeteryHiddenWould you like to include one small pumpkin per student to your visit? Yes NoThis is only applicable to school groups visiting during the month of October. Pre-payment is required for pumpkins. Pumpkins are subject to market pricing.Would you like to include one small pumpkin per student to your visit? Yes NoThis is only applicable to school groups visiting during the month of October. Pre-payment is required for pumpkins. Pumpkins are subject to market pricing.CommentsThis field is for validation purposes and should be left unchanged.