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Skirball Cultural Center

2701 N. Sepulveda Blvd, Los Angeles, CA 90049 - (310) 440-4500
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School Tour Request Grade 3


School Tour Request Form - Grade 3
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
Check one (*)
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School District (*)
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Local district # (LAUSD only)
Are you a Title 1 school?
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TEACHER CONTACT INFORMATION
Teacher Name (*)
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Position (*)
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Contact Phone (*)
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Alternate Phone - Please provide phone number to be used on the day of the visit. (*)
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Main Contact Email (*)
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Email addresses for all other teachers attending with you.
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Names of all teachers attending this field 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 (min.15; max. 60) (*)
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Estimated number of chaperones
(teachers and parents, max. 10) (*)
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SPECIAL NEEDS*
*Information on your students' special needs (learning disabilities, physical limitations, gifted, ELL, etc.) helps us customize and plan your visit.
(*)
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Additional Comments
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SCHEDULING INFORMATION
  • Please select three dates when you would like to schedule your gallery program.
    We will make every effort to accommodate you.
  • All dates are filled in the order received.
  • Gallery programs are available Tuesday-Friday, September 2014-June 2015.
  • At Home in Los Angeles gallery programs begin at 10:00 a.m., except where noted and last 2 hours.
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    First Choice (*)
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    Second Choice (*)
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    Third Choice (*)
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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)
    Admission Scholarship

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    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.
    In order to be considered for an admission and/or a bus scholarship, please answer the following questions:
    1. What financial restraints prevent you from paying the admission and/or the bus 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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    If your form has been submitted successfully, you will receive an automated email. If not, email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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