Revelations (Schooltime Performance) Request
**SUBMISSION OF THIS REQUEST FORM IS NOT CONFIRMATION OF YOUR TRIP! TRIPS WILL ONLY BE CONFIRMED WHEN PAYMENT IS RECEIVED IN FULL.** Once the completed form is submitted, a member from our team will follow up within 3-5 business days. If you have any questions, please contact our Box Office at (718) 793-8080 or boxoffice@kupferbergcenter.org
Name
*
First Name
Last Name
School Name:
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Phone Number
*
Please enter a valid phone number.
Cell Phone Number
*
Please enter a valid phone number.
Work Email
*
example@example.com
Best Time to Contact You
*
Requesting Performance(s)
*
Total Number of Teachers (Free) Per Event
*
Total Number of Parents (Tickets Required) Per Event
Total Number of Students Per Event
*
Total Number of Paras/Nurses Per Event
Grade(s) Attending Per Event
*
ADA Seating Needs Per Event (Wheelchair/Mobility Issues)
*
Approx. Number of Buses Per Event
*
Are you with a Title 1 School?
Yes
No
Submit
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