Discovery Lab on Wheels Interest Form

Bring the Museum to your classroom or organization for fun hands on activities with the Fort Worth Museum of Science and History’s Discovery Lab on Wheels program.

School/Center Name:

Contact Person

Street Address

City and State

Zip Code

Phone Number

Email

Grade Level/Age Range

Number of Students Participating

Number of Classes (Our programs are designed for up to 30 students at one time. We are able to do multiple classes for large groups of students)

What Program(s) are you Interested in?

1st Date Choice

MonthDayYear

2nd Date Choice

Date

3rd Date Choice

MonthDayYear

Proposed Start Time (Programs cannot start prior to 8:30. Programs are offered between 8:30am-5:00pm)

Hour Minutes

AM/PM Option

Special Instructions: Is there anything that we should know about your school or facility prior to arriving? (parking, loading area, main office location, etc.)