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* 1. Name of School

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* 2. Teacher Name(s)

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* 3. Email address(es)

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* 4. School Phone Number

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* 5. Grade(s)

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* 6. Class Size(s) (Maximum Capacity: 26 students)

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* 7. Mode of Transportation

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* 8. Top 3 Dates (Tues - Fri, Nov 12 - Dec 13) / Times (Gr 2 & 9: 9:15 am or 12:00 pm; Gr 7: 9:15 am)

First Choice
Second Choice
Third Choice

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* 9. Special Accommodations

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