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Contact Name: _______________________________________________
Group Name: _______________________________________________
Street Address: ______________________________________________
City: ______________________ State: _____ Zip Code: ___________
Daytime phone: __________________ Nighttime phone:________________
Fax Number: ____________________ E-mail: ______________________
No. in Group: ____
Please choose from the tour options below:
__ Dispelling the Myths
__ Grand Survey
__ Footsteps & Foundations
Living History: __ Check here if you want a living history character on your tour.
Group Profile: Please identify any special needs your group might have so we can better prepare for your visit.
Special Education: ____________________________________________________
Physical Disabilities: ___________________________________________________
Other: ________________________________________________________
Requested Dates:
1st Choice
| Day/Date of visit: __________________ | Arrival Time:_____________ |
| Departure Time:__________ |
2nd Choice
| Day/Date of visit: __________________ | Arrival Time:_____________ |
| Departure Time:__________ |
Qustions? Call the Old State House Museum Education Department at (501) 324-9685.
MAIL completed reservation forms to:
Old State House Museum
ATTN: Education Department/Tour Coordinator
300 West Markham
Little Rock, AR 72201
FAX completed reservation forms to:
Old State House Museum
ATTN: Education Department/Tour Coordinator
(501) 324-9688
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