Field Trip Request Form Staheli Family Farm

Contact Name*
First Last
School Name*
Grade
Email*
Enter Email Confirm Email
Phone*
Are You Eating Lunch at the Farm?*
- Yes
- No
(Students must provide own lunch)
How Many Students will be Attending?*
Arrival Time

: Hours

Minutes

AM/PM
Departure Time

: Hours

Minutes

AM/PM
Please provide your top 3 dates that you are requesting. We will contact you with which date(s) will work.
Date Requested 1
MM slash DD slash YYYY
Date Requested 2
MM slash DD slash YYYY
Date Requested 3
MM slash DD slash YYYY
Click the red "SUBMIT" button below, then wait...
Wait a moment to make certain your form is accepted. You'll receive a confirmation message AT THE TOP OF THIS PAGE if your request is complete. Errors will be marked in RED until corrected.