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 – $19 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 PREFERENCE
First Choice
MM slash DD slash YYYY
Second Choice
MM slash DD slash YYYY
Third Choice
MM slash DD slash YYYY
Deposit
I have read about and agree with the deposit and payment policy.
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