Request a Program

Do you have a complex scheduling request?

Yes- If so, please e-mail eduinfo@cmnh.org for a spreadsheet to fill out and stop filling out this form.No my request is simple, 1-2 programs

School/Organization Name. *Provide full name of your school or organization (not an abbreviation): *

Are you a Title 1 school in Ohio, (the number of economically disadvantaged students is 40% or above)? You can check at this website under school details: https://reportcard.education.ohio.gov/. Title 1 schools in Ohio may qualify for free programming, first come first served while grant funding lasts. *

Are you using the Ohio DLA grant to fund your request?

YesNo

Is your school from one of these counties? Select county if so.

School / Organization Street Address:*

School / Organization City: *

Select country:

Select state (if USA):*

School / Organization Zip Code (if USA):

School Contact (First and Last Name):*

Best phone number to reach you (if USA):*

Phone type: *

School/ Organization PhoneCell PhoneHome Phone

Best e-mail address to reach you:*

Preferred Method of Contact:

Phone is preferredE-mail is preferred

If by phone, what are the best days and times of the week to reach you?:

Date

Hour MinutesAM/PM Option

Date

Hour MinutesAM/PM Option

Preferred Program Time(s):

Alternate Program Date(s) and time(s):

If we can't accomodate your first or second choice date and time, what days of week and times work for you and your students overall?

How did you hear about our educational programs?*

If Facebook group, through which group did you hear about us?

Number of Students: *

Number of Students*

Number of Chaperones (if applicable):*

Grade level(s) of students:*

If multiple grades, estimated number of students or classes per grade level:

Please select your program type:*

At the Museum - Guided, Planetarium, and Live Animal Programs: $15/student, PreK-12, $300 minimum fee for fewer than 20 students. Important note: Lunch space is limited.At the Museum - Self-Guided: $10/student, PreK-12, $200 minimum fee for fewer than 20 students. Important note: Lunch space is limited.Single-point Virtual Program - $210/program (single connection, 30 students max)Multi-point Virtual Program - $300/program (multiple connections/over 30 students)Science-to-Go - $400/2 programs, same school, same day

Virtual Programming

Science-to-Go