Community Booth Request

Contact Information

Name of Primary Contact

Name of School or Group

Address

City

Telephone Number

Email Address

Community Booth Information

Type of Event

Community Center/Library

Outdoor Special Event

STEM Event run by School

Other, please provide details

If you selected "Other" on the question above, please specify below.

Program Requested

Saving our Bosque

How Do I Grow?

Reproduction of the Fittest

Group Survival

Wild Cats and their Prey

Beneficial Bugs

We encourage you to remain flexible in order to meet the needs of your event and our animals.

Event Date

If the date is flexible, please provide three (3) date options

Program Start Time

Program End Time

Location

Within 25 miles of Albuquerque City Center

25 – 50 miles from Albuquerque City Center

50 – 100 miles from Albuquerque City Center

Over 100 miles from Albuquerque City Center

Method of Payment

Need PO

Credit Card

Check

Will financial assistance be needed?

Yes

No

If financial assistance is needed, please answer all of the questions in the section below.

Financial Assistance Questions If you answered yes to the question above, please complete all of the questions below.

What County?

What School District?

List your organization's participation in public or private assistance programs and/or provide us with an understanding of your financial need.

Examples include Free and Reduced Lunch, Medicare/Medicaid, Aid to Families with Dependent Children.

Why do you want your class to participate in the Discover the BioPark Program?

How will this field trip or classroom visit connect to your classroom lessons?

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