Field Trip Registration Form - Kentucky Historical Society

Scheduler's Name*

First Last

Scheduler's Email*

School Name*

School Phone Number*

School Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Grade*

Number of Students*

Total Number of Adults*

We require 1 adult per 10 students. Include teachers and chaperones.

Three Field Trip Dates in Order of Preference*

Note: We are closed on Mondays.

Special Needs

Tell us if there are special needs we should consider to better prepare to work with your students.

Build Your Own Field Trip

Check all of the components that you want to include in your visit.

Self-Guided Exhibit (60 minutes)

A Kentucky Journey

Self-Guided Exhibit (through Oct. 14, 2017)

People of Kentucky

Self-Guided Exhibit (at KY Military History Museum)

Kentucky Military History Treasures

Guided Tour (60 minutes)

Old State Capitol

Maximum Group Size: 100

Learning Lab Option 1

Artifact Analysis

Cost: $2 per student per lab. Time: 60 minutes. Max group size: 40

Learning Lab Option 2

Maker Space

Cost: $2 per student per lab. Time: 60 minutes. Max group size: 40

Learning Lab Option 3

Performance Workshop

Cost: $2 per student per lab. Time: 60 minutes. Max group size: 40

Learning Lab Option 4

Research Project

Cost: $2 per student per lab. Time: 60 minutes. Max group size: 40

Lunch

Check the box if you want to reserve space for lunch (times available in 30-minute increments).

Reserve Space for Lunch

Stewart Home School 1792 Store

Check the box if your group would like to visit the Stewart Home School 1792 Store. The maximum number of students allowed in the store at one time is 30. A chaperone must be present.

We want to go to the 1792 Store

Payment and Confirmation

Payment is due on the day you visit. You may pay by cash, check (made out to the Kentucky Historical Society), credit card (Visa, MasterCard or American Express) or purchase order. You will receive confirmation of your field trip from a KHS staff member within 5 business days of our receiving your request.