Elementary Education Program Form

Your Information

First Name*

Last Name*

Email*

Telephone*

School Information

School Name*

School District*

School Address*

Grade Level - check all that apply
Pre-KK12345

Program Information

Program Selection:

Setting the Scene: Macaroni BoyWe're All ImmigrantsGlass: Shattering NotionsPittsburgh's PastHealthy Heritage


Number of Students*

Number of Classes*

Number of Teachers*

Number of Chaperones*

Preferred Dates*
1.

2.

3.

Time of Arrival*:

Time of Departure*:

Lunch Choices: No lunchBrown bag lunch (lunchroom space provided)Box lunch from the Museum Café (lunchroom space provided)

Would you like students to visit the Museum Shop?

YesNo