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Skirball Cultural Center

2701 N. Sepulveda Blvd, Los Angeles, CA 90049 - (310) 440-4500
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Performing Arts Request Form


Performing Arts Program Request Form

SCHOOL INFORMATION
School Name
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Address
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City
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State
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ZIP
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Current Principal
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Phone
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Fax
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School District
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Local district # (LAUSD only)
If not applicable, type "none"
TEACHER CONTACT INFORMATION
Teacher Name
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Position
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Contact Phone
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Alternate Phone
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Email Address
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Names of other teachers attending trip
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Is this the first time you are bringing students to the Skirball on a field trip?

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If NO, how many years have you been bringing your classes on field trips?

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If YES, who referred you to the Skirball?

CLASS INFORMATION
Grade Level
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Estimated # of students (15-40)
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Estimate number of chaperones
(teachers and parents, max. 10)

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SPECIAL NEEDS*
*Information on your students' special needs (physical limitations, etc.) helps us customize and plan your visit.

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SCHEDULING INFORMATION
Please limit your request to 60 students. (Larger groups must to be approved by the Skirball).
All gallery programs begin at 10:00 a.m., except where noted and last 1.5 to 2 hours.


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TRANSPORTATION AND ADMISSION SCHOLARSHIPS (Public schools only)
Scholarship Applications (YOU MUST check each box to indicate your understanding of the terms of these agreements). Confirmation of your bus and/or admission scholarship will be indicated in your confirmation email.
Bus Scholarship Terms








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If you need assistance finding a bus company, the Skirball has an account with American Transportation Systems. For more information please visit its website at www.amtrans.us or call (562) 531-8000 and ask to speak with Ruth Ann.
Admission Scholarship


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In order to be considered for an admission scholarship, please answer the following questions:
1. What financial restraints prevent you from paying the admission fee? (limited to 150 words)

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2. How will a visit to the Skirball supplement your classroom curriculum? (limited to 150 words)

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3. How does the Skirball's mission dovetail with your teaching practices? (limited to 150 words)

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