Field Trip Request Form

Field Trip Request Form
Fill out the form below to start your registration for a Field Trip to any of our Unity In Learning locations, including Ann Arbor Hands-On Museum, Leslie Science & Nature Center, and Yankee Air Museum.

Plan an adventure with your students where knowledge is your destination.
- Once you've completed the form a Unity In Learning representative will call you to confirm date, time and program availability. Reservation requests are not guaranteed until you speak with a Unity In Learning representative.
- For visits to Ann Arbor Hands-On Museum you will have a chance to apply for a scholarship from the Discover Science Assistance Fund starting on page 2.
- A confirmation letter and/or invoice will be sent via email following your conversation with a Unity In Learning Representative.
- For more information please contact the Field Trip Coordinator at 734.995.5439 or click here to send an email.
Name of School/Organization*
Name of Teacher/Contact*

First NameLast Name
School Phone*
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email*
example@example.com
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which location would you like to visit?*

Ann Arbor Hands-On MuseumLeslie Science & Nature CenterYankee Air Museum
Do you have a discount code?

Discover Science Assistance Fund
The Discover Science Assistance Fund offers need-based scholarships for a portion of the fees for field trips to Ann Arbor Hands-On Museum. These funds are made possible by the generosity of many friends of the Ann Arbor Hands-On Museum. Scholarship funds are not available for field trips to other locations at this time.
Would you like to apply for a scholarship*

YesNo
Scholarship Eligibility
Please fill out the information below to help us determine your eligibility for a scholarship through the Discover Science Assistance Fund.
Brief statement of why you need assistance*
% Receiving Lunches
Percentage of Students Receiving Free/Reduced Lunches
% Receiving Scholarships
Percentage of Students Receiving Admissions Scholarships (If you're not a private school, please enter 0%

Science Works Labs
If you would like to sign up for a ScienceWorks Lab, please enter the number of students that would be participating in each lab. The fee is only for students; don't include teachers or chaperones when entering numbers.

Preschool labs: $4 per student

Preschool labs are booked for a minimum of 15 students with a minimum price of $60.
All About Our Senses (Preschool)
Number of students attending
Standard Labs: $6 per student

Standard labs are booked for a minimum of 15 students with a minimum price of $90.
Engineering Design (K - 2nd grade)
Number of students attending
Slime Time! (K - 2nd grade)
Number of students attending
Marvelous Magnets (K - 3rd grade)
Number of students attending
Water Cycle (2nd - 4th)
Number of students attending
Cow Eye Dissection (5th-8th)
Number of students attending

Please submit your form. Your Field Trip is not reserved until our staff have contacted you to confirm availability.
- After you submit, a Unity In Learning representative will call you to confirm date, time and program availability. Reservation requests are not guaranteed until you speak with a Unity In Learning representative.
- A confirmation letter and/or invoice will be sent via email following your conversation with a Unity In Learning Representative.
For more information please contact the Field Trip Coordinator at 734.995.5439 or click here to send an email.
Please verify that you are human*
Should be Empty:

Discover Science Assistance Fund