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Virtual Field Trip Reservation Form

High School Virtual Field Trip Reservation Form

To schedule a virtual lesson, please fill out the following form. Requests must be submitted at least two weeks in advance of lesson date.

Questions? Contact the Education Team at (619) 398-8271 or EducationReservations@midway.org.

Step 1 of 4

Primary Contact:
Name*
First Last
Title*
Phone*
Email*

School/Institution:
Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Information:
Name*
First Last
Institution*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Class Information:
# of Students
Grade Level
Teacher name
How will this lesson relate to your curriculum? Any information you provide will help us to relate this lesson more directly to your studies.
Class Subject Information*
Lesson Date and Time:
This program requires up to 60 minutes per class. Virtual Field Trips are available Tuesday through Friday between 9 am and 2 pm PST. Please submit your request at least 2 weeks in advance of your requested lesson date.
1st Choice Date*
MM slash DD slash YYYY
1st Choice Time*

: Hours

Minutes

AM/PM
2nd Choice Date*
MM slash DD slash YYYY
2nd Choice Time*

: Hours

Minutes

AM/PM
Test Call Date and Time:
Tuesday through Friday between 9:00 AM and 2:00 PM Pacific Standard Time. We suggest scheduling a test call approximately one week prior.
1st Test Date Choice*
MM slash DD slash YYYY
1st Test Date Time*

: Hours

Minutes

AM/PM
2nd Test Date Choice:*
MM slash DD slash YYYY
2nd Test Date Time*

: Hours

Minutes

AM/PM
Midway uses GoToMeeting.com for our Virtual Field Trip lessons. You will need an internet connection, a projector or interactive whiteboard, speakers and microphone so that students can interact with our museum educator.
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