Education Program Application

James River Association Education & Outreach
School and Group Program Application
Section 1: Contact Information
School or Organization Name*
School District
Work Phone*

Area CodePhone Number
Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Teacher/Leader Contact*

First NameLast Name
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Email*
Personal Email
Section Two: Group and Program Information

Please Note: If you are committed to providing students with quality outdoor learning experiences, but are limited by funds, please Contact JRA for information about need-based scholarships for appropriate individuals and schools.
Class Name or Group*
Grade Level or Age*
JRA Program Requested*

Ecology School Overnight Program (3-day; max 34 participants)Ecology School Overnight Program; (2 -Day; max 34 participants)Ecology School Day Program (1-day; max 34 participants)Ecology School Wet Feet Weekend (youth group 2-day, max 34 participants)River Explorations Paddle Program (1-day, max 28 participants)Watershed Classrooms (45 minute in-classroom presentation)James A. Buzzard Education Center Program
Number of Programs Requested*
Number of Particpants Per Program (including adults)*
Section Three: Date and Times

Please list ranges of all dates available. The more dates you list the better chance we will be able to book your program. Field programs generally run March through June and September through November. Summer dates available by special request.
List All Available Dates or Ranges of Available Dates*
Weekdays assumed for all programs other than Wet Feet Weekend.
Preferred Program Dates
Assigned on first-come, first-served basis.
Other Notes for Program Scheduling:
Time Class Can Depart School in Morning
Time Class Must Be Back at School in Afternoon
Section Four: Program Options and Details
Ecology School 3-Day Program Area of Study*

Watershed SystemsLife ScienceEarth ScienceBiologyEnvironmental ScienceVirginia Studies
Ecology School 2-Day Program Area of Study*

Watershed SystemsLife ScienceEarth ScienceBiologyEnvironmental ScienceVirginia Studies
Ecology School Day Program Area of Study*

Watershed SystemsLife ScienceEarth ScienceBiologyEnvironmental ScienceVirginia Studies
Watershed Classrooms Topic Choice (CHOOSE ONE)*

Watersheds 101Pollution SolutionsGuest Speaker on James River Topic (indicated topic below)
What specific topics or learning goals would you like the JRA program to support?
What post-trip activities or lessons would you like the JRA program to support (ie type of data gathered, student journaling, etc.)?
Should be Empty:

James River Association Education & Outreach

School and Group Program Application

Section 1: Contact Information

Section Two: Group and Program Information

Section Three: Date and Times

Section Four: Program Options and Details