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Home » Education » SHARP Literacy Program Request Form

SHARP Literacy Program Request Form

Fields marked with an asterisk (*) are required.

"*" indicates required fields

Main Contact & School Information

Full Name*

Prefix First Last Suffix

Job Title / Position*

School Phone Number*

Alternate Phone Number*

Email*

School Name*

School Address*

Street Address City State ZIP Code

Confirmation materials will be provided via email. When we send those materials, we can copy your principal and/or any other individuals as well. If you'd like other contacts included, please list their full name(s) and email address(es) in the space provided below.

Is this your first time booking a SHARP Literacy program with us?*

Group Information

Grade Level of Students*

Estimated # of Students*

Estimated or Max # of Adults (Minimum Requirement is 1 for Every 10 Students/Children Attending)*

Preferred Visit Date

1st Choice Date – Mondays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

1st Choice Date – Fridays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

2nd Choice Date – Mondays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

2nd Choice Date – Fridays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

3rd Choice Date – Mondays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

3rd Choice Date – Fridays Only*

All requests must be made at least three (3) weeks in advance or more from your desired visit date.

MM slash DD slash YYYY

Timing Preference

Preferred Time Slot for 2nd Grade Groups*

There is a 60 student maximum limit for each time slot.

9:45 AM – 11:30 AM

11:45 AM – 1:30 PM

Preferred Time Slot for 3rd Grade Groups*

There is a 40 student maximum limit for each time slot.

9:45 AM – 11:30 AM

11:45 AM – 1:30 PM

Additional Questions

Does anyone in your group have any special needs or accommodations to note?*

If you have any attendees that need special accommodations or considerations that we should be aware of, please let us know by using the boxes below.(Examples include attendees who are in wheelchairs, attendees with individual aides, attendees who are English Language Learners and are bringing an interpreter, attendees who are deaf or hard of hearing that are bringing an interpreter, etc.) We may reach out to you if we have any follow-up questions or need to share any information.

N/A

Our group has individuals who use a wheelchair or crutches.

Our group has individuals who have 1:1 aides.

Our group has individuals who are English Language Learners.

Our group has individuals who will be bringing their own interpreter.

Our group has individuals who are deaf or are hard of hearing.

Other

If you checked "Other" in the question above, please specify the other special accommodations or considerations to share.*

Does anyone in your group have severe allergies to note?*

An inherent risk of exposure to allergens exists in any public place where people are present. By visiting Discovery World, you voluntarily assume all risks related to exposure of allergens.

N/A

Peanut Allergies

Treenut Allergies

Shellfish Allergies

Other

If you checked "Other" in the question above, please specify the other severe allergies to share.*

Please list any additional notes, requests, program preferences, and/or any other special information we should know.

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Comments

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