Request for Summer Group Visit Request for Summer Group Visit Please enable JavaScript in your browser to complete this form.We look forward to hosting your group at The Schiele Museum! Please note that submitting this form does not guarantee an appointment. Our staff will respond to your request, book your appointment, then send email a written confirmation of that appointment. Fields marked with an asterisk (*) must be completed. Primary Contact's InformationName *FirstLastTitleEmail *Day of visit phone numberGroup InformationGroup Name *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *# Participants Attending *Participant grade levels *Pre-KK123456789101112TransportationSELECTBusCar/Caravan15 passenger van/sFirst Date Choice *First Choice Arrival Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PMFirst Choice Departure Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12.00 PM12.30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PMSecond Date Choice *Second Choice Arrival Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PMSecond Choice Departure Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PMThird Date ChoiceThird Choice Arrival Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PMThird Choice Departure Time *SELECT9:00 AM9:30 AM10.00 AM10.30 AM11.00 AM11.30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PMAdded Programs Your group visit includes museum exhibits, admission to The Farm, and access to the Nature Trail for $5+tax per participant. Select up to three additional programs to enhance your museum experience! Program Selection(s):Animal Adventures - add $3 per participantGemstone Mining - add $4 per participantPlanetarium Show - add $5+tax per participant (Indicate desired title in SPECIAL REQUESTS section.)Lunch Plans *SELECTWe are not staying for lunchWe would like to eat while on our visitSpecial Requests or NeedsSubscribe to The Schiele's eNewsletter* *YesNoIf you do not hear from us within 3 business days after completing this form, please call our group scheduling coordinator at 704.854.6676.Submit