Outreach Program Inquiry

Name

First Name Last Name

Title

Email

example@example.com

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Organization funding proposed program

Proposed location of program

Primary area of interest (check all that apply)

Single session out-of-school program Multi session out-of-school program Programming during school hours/in-school All day school events/field trips STEAM/Art/Science nights Community festival Social event programming/activity for adults Other

Desired dates of programming if known

Desired times of programming if known

Ages of participants

Approximate number of participants

Please list any programming subject matter or specific RIMOSA program/suite that interests you.

Do you need a Spanish-speaking Educator?

Yes No

Please list any other information you'd like us to consider as part of your inquiry.

Thank you for your inquiry! RIMOSA's Education Director review be in touch shortly. If you have questions please reach out to Desiree Brunton: dbrunton@rimosa.org