School Outreach Program/Onsite Field Trip/Tour Request

Education and Outreach Program Request

Offsite Classroom Outreach║Field Trip║Scout Program║Tour
Disclaimer

*PLEASE READ FIRST*

The Arizona Humane Society offers education programs (both on and offsite) that provide both youth and adults with an understanding of the lifesaving work we do in our community. Our ultimate goal is to instill empathy and create a more compassionate society.

All programs provide age/grade appropriate lessons and are easily customized to fit the needs of your group.
- Programs are provided free of charge to Title 1 schools in Maricopa County.
- All onsite programming (field trips/ tours) are facilitated at our Nina Mason Pulliam South Mountain Campus (1521 W. Dobbins Road, Phoenix, AZ, 85041).
Do the program specifics above align with your expectations for your educational experience?

Education and Outreach Program Request

Offsite Classroom Outreach║Field Trip║Scout Program║Tour
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Expected Attendance
Requested Date and Time

MonthDayYear
DateHourMinutesAM/PM Option
Secondary Alternative Date and Time

MonthDayYear
DateHourMinutesAM/PM Option
Third Alternative Date and Time

MonthDayYear
DateHourMinutesAM/PM Option
Special Requests/Accommodations
How did you hear about us?
What type of program are you interested in?

Offsite Classroom Outreach
School Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this a Title 1 school in Maricopa County?

YesNo
District Name
Grade Level(s) of Students
Program Theme

Pet TalkClassy CrittersAnimal DoctorsAnimal Rescue SquadToo Much of a Good ThingAnimal Advocates 101

Scout Program
Scout Level (select all that apply)

DaisesBrowniesJuniorsCadets
Troop Number
Would you like to add on 'Reading Fur Fun' – a half-hour of reading and interaction with our dogs and cats for an additional $50.00?

Yes (program will be extended to 2 hours)No (program will remain 1.5 hours)
Names of participating scouts for certificates of completion

Education and Outreach Program Request

Offsite Classroom Outreach║Field Trip║Scout Program║Tour
We're sorry our Offsite Classroom Outreach/Field Trip/Scout Program/Tour Request does not meet your expectations. Please check out our alternative youth service learning packet, cuddle bunch and reading fur fun programs.
Should be Empty:

Offsite Classroom Outreach