SCHOOL/GROUP TOUR REQUEST FORM

Preferred Tour Date:                Time:    to

Alternative Tour Date:              Time:    to

School/Group Name:        Phone:   

Contact Person:                Fax:   

Address:            Email:   

Grade:      No# of students:   Chaperones (1 per 10 students FREE)   Additional Adults
                                                                        (Others are additional adults)

Comments, notes, special arrangements, study focus, etc.:

Please check which areas you prefer to tour:

    Museum & Historic Home     Cost:    $2.50 per students / $7.00 per additional adult
    Museum only                         Cost:    $1.50 per student / $5.00 per additional adult
    Historic Home only                Cost    $1.00 per student / $3.00 per additional adult

*For groups other than school groups rates vary please contact the museum for price quotes.

COST PER STUDENT:    $ X = $

ADDITIONAL ADULTS: $ X = $

                                                                                                    TOTAL = $

How will you make payment:
    PO#        Check        Cash        Credit Card

Signature (Please fill in full name)    Date

 ***LYMAN MUSEUM STAFF WILL SEND A CONFIRMATION OF YOUR TOUR RESERVATIONS***
If you have any questions please call the Education Department at (808) 935-5021.