Contact Name: _______________________________________________
School Name: _______________________________________________
Street Address: ______________________________________________
City: ______________________
State: _____
Zip Code: ___________
Daytime phone: __________________
Nighttime phone: ________________
Fax Number: ____________________
E-mail: ______________________
Grade Level: ____________
No. of Students: _________
No. of Teachers with group: ____
No. of chaperones with group: ______
Please choose a tour option for your group:
__ Capital Close-Up
__ Explorers
__ Footsteps & Foundations | |
__ Governor's Review
__ Grand Survey
__ Visionaries |
If you want to schedule a program with your tour, please choose from the options below:
__ Buttons Up! Political Imagery through
Campaign Buttons
__ Civil War in Arkansas
__ Legislative Process
__ 19th Century Games
__ 19th Century Historic Arts
__ Legislative Process
__ What Women Wore During the Civil War
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:__________ |
NOTE: Before arranging transportation, be sure your date and time have been confirmed.
If you have additional questions about the tour policies or program offerings, please call the Old State House Museum Education Department at (501) 324-9685. Thank you.
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