Field Trip Registration Form

ENVIRONMENTAL EDUCATION CENTER

8695 Broadway, Merrillville, IN 46410
(219) 853-2420

Field trips begin at 10:00 am and end by 1:00 pm. (Lunch facilities for sack lunches are available).
All trips are held at the Environmental Education Center: 8695 Broadway, Merrillville.
Multiple days may be required depending on number of classes being registered.

Contact Name *

Email Address *

School Name *

School Address *

City / State *

Grade Level *

# of Classes *

School Phone Number *

Cell Phone *

Number of Students *

Please select (√) a program listed below *

All About Water
Reduce, Reuse, Recycle
Composting and Food Waste
All About Trash
Plastics Investigation
Healthy Homes and Habitats

Please provide three (3) possible dates for your field trip as they are scheduled on a first come, first serve basis.
If you plan to have a large group (consisting of 60 ), consecutive or multiple dates may apply.

1^st Date Choice *

2^nd Date Choice *

3^rd Date Choice *

School Start Date *

Spring Break Start Date *

Additional information to assist scheduling