Teacher Name
*
First Name
Last Name
School Name
*
School classification
Public
Private
Homeschool
Charter
Pods
Teacher's grade level
1st - 8th st
Special Area Teacher
Total Students in Class
Have you previously reserved a field trip at the Betty Brinn Children’s Museum through a Kohl’s Foundation grant?
Yes
No
While this is not a requirement, please help us learn more and check the box if it applies
At least 50% of our student population qualifies for reduced and/or free lunches
If you are able, let us know how you plan on utilizing our Connect & Learn grant for your students?
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