Please fill out the form completely. After submitting your request, Jean will contact you for further confirmation. Name* First Last Email* Work Phone*Cell Phone*In case communication is needed on day of the tripName of Organization/School*School Administrator issuing check name First Last Administrator Email Has your group attended the Planetarium Before?*YesNo1st Date Preferred* Please choose a date that is 2 weeks from today's date.2nd Date Preferred* 3rd Date Preferred* Earliest Start Time* : HH MM AM PM Latest End Time* : HH MM AM PM Grade Level Attending*Number of Chaperones Attending*Number of Students Attending*Less than 2222-4444-68Optional Hands-on activityEarth's Amazing Moon (K4-G4)Solar Systems to Scale (G2-8)Star Charts (G5-12)Each show depends on what grade level and the amount of students participatingPlease insert any addition comments the Show Coordinator should know about: Payment Information To hold your reservation please mail a check of $XX made payable to the UWM Planetarium Planetarium/Physics Department UWM P.O. Box 413 Milwaukee, WI 53201-0413 **Please note: after submission, you will be notified with the due amount.