EIC Scheduler

University of Michigan-Dearborn

Environmental Interpretive Center

Group Program Registration Request - Topic Combinations

We have a limited number of Topic Combinations that can run back-to-back, over the course of 3 ½ to 4 hours (including a half hour lunch break) for a maximum of 70 children in one day. For topic combinations, one group would attend one program in the morning, while the other group starts with the other topic. After the lunch break, the groups would switch. All topic combinations involve a Pond Explorations program PLUS one other program.

Teacher/Group Leader 1 last name*

Teacher/Group Leader 1 first name*

Teacher/Group Leader 1 email address*

Confirm Teacher/Group Leader 1 email address*

Teacher 1 cell phone number* (Required format: xxx-xxx-xxxx)

Good time to reach Teacher/Group Leader 1 by phone* (If email preferred, please enter "Email preferred")

Teacher/Group Leader 2 last name

Teacher/Group Leader 2 first name

Teacher/Group Leader 2 email address

Confirm Teacher/Group Leader 2 email address

Teacher 2 cell phone number (Required format: xxx-xxx-xxxx)

Good time to reach Teacher/Group Leader 2 by phone (If email preferred, please enter "Email preferred")

School*

Grade level(s)*

Total number of students* (We request a minimum of 10 students and a maximum of 70)

Number of adult chaperones* (We request a minimum of 1 adult chaperone per 10 students)

Preferred date(s) and start time(s)

1st preference*

2nd preference

3rd preference

Is your group bringing lunch? (Lunch is not provided by the University)

Does your group require any special accommodations?

Please make sure that you submit your program request. You will receive a confirmation email upon successful submission of your program request.