Name: Lowrance Reporting Service, Inc.
Address: 100 Tellus Drive, Cartersville, GA, 30120, US
Telephone: 770-606-5700
Price range: -

FIELD TRIP RESERVATION FORM
CONTACT INFORMATION
School Name:
Contact Name
Address*
Street Address Address Line 2 City State ZIP Code
County*
Phone*
Cell Number
Primary Email*
Secondary Email*
PROGRAM PARTICIPANTS
Grade*
Number of students*
Minimum of 15 students required.
Approximate number of teachers*
Approximate number of parents/chaperones*
One FREE with every 10 students. Additional parents and chaperones – $20 each
YOUR PROGRAM
My preferred program is:*

Please view “Programs By Grade” or “Programs by Gallery” and then choose a grade appropriate field trip program and complete the field below. Ex: Fossiliferous
START TIMES*
- 10 AM - Arrive at 9:30 AM for check-in
- 10:30 AM - Arrive at 10 AM for check-in
PLANETARIUM ADD-ON
Would you like to add a planetarium show?

Please note that all programs in the Millar Science in Motion Gallery include a planetarium show. By selecting "Yes", you are choosing to add an additional show.
- Yes, I would like to add a 1 PM planetarium show.
- Yes, I would like to add a 1:45 PM planetarium show.
- No, I do not want to add a planetarium show.
DATE PREFERANCE
First Choice
MM slash DD slash YYYY
Second Choice
MM slash DD slash YYYY
Third Choice
MM slash DD slash YYYY
This field is hidden when viewing the form
Deposit
I have read about and agree with the deposit and payment policy.
Additional Comments
For more information contact Central Scheduling by calling 770-606-5699 or email at scheduling@tellusmuseum.org

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FIELD TRIP RESERVATION FORM

CONTACT INFORMATION