Tour / Program Request Form Your Information First Name* Last Name* Email* Telephone* School Information (if applicable) School Name School District School Address Age Level - check all that apply Pre-KK123456789101112CollegeAdultSenior Number of Students* Number of Chaperones Preferred Dates* 1. 2. 3. Time of Arrival*: Time of Departure*: Would you like the group to visit the Museum Shop? YesNo Please briefly explain what you're looking for in a tour or program with the Fort Pitt Museum.* How did you hear about tours at the Fort Pitt Museum? Do you want to sign up for the History Center's teacher email newsletter? YesNo Do you want to sign up for Fort Pitt's email newsletter? YesNo