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

FIELD TRIP RESERVATION FORM
This form is only valid for the 2021-2022 school year.
CONTACT INFORMATION
School Name:
Contact Name
Mailing Address*
County
Phone*
Cell Number
Email*
PROGRAM PARTICIPANTS
Grade*
Number of students*

Minimum of 15 students required.
Approximate number of teachers*
Approximate number of parents/chaperones*
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
- 11 AM - Arrive at 10:30 AM for check-in
- I prefer afternoon options.
PLANETARIUM ADD-ON
Would you like to add a planetarium show?
- Yes, I would like to add a planetarium show.
- No, I do not want to add a planetarium show.
DATE PREFERENCE
*Please note, we are only taking reservations for the 2021-22 school year.
First Choice
MM slash DD slash YYYY
Second Choice
MM slash DD slash YYYY
Third Choice
MM slash DD slash YYYY
For more information contact Asia Johnson in scheduling by calling 770-606-5699 or email at asiaj@tellusmuseum.org

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FIELD TRIP RESERVATION FORM

CONTACT INFORMATION