| School Name |
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| Address of School (City, State, Zip) |
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| Lead Teacher Name |
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| Lead Teacher Mailing Address |
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* |
| City, State |
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* |
| Zip Code |
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* |
| Lead Teacher Phone Number |
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* |
| Lead Teacher Email Address |
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* |
| Mobile Phone Number/Contact Number on day of visit |
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* |
| Preferred Date of Program (Please indicate your first and second choice of the two available dates) |
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* |
| Preferred Arrival Time |
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* |
| Preferred Departure Time |
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| Number of Chaperones Attending (Note: One adult chaperone per ten students is required and will be admitted free of charge) |
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* |
| Number of Student Participants |
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* |
| Grade Level |
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* |
| Do you have a Baseball Hall of Fame Membership? (Note: Among other benefits, Hall of Fame Members receive a discount of $1.00 per student) |
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* |
| If Yes, Member Name |
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| Form of Payment (Note: All payment must be received on or before the date of the scheduled program) |
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* |
| Does your group, or any member of your group, have any special needs that you would like us to be aware of? If yes, please specify. |
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| Will your students be visiting the Museum Store during their time at the Baseball Hall of Fame? |
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| Have you ever participated in the Baseball Hall of Fame's Education program before? |
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* |
| How did you hear about our education program? |
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* |
| Comments |
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