Reservation


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Four Ways to Register

BY PHONE

Please call 613-991-3053 or
Toll Free 1-866-442-4416

BY FAX

Please print and fill out this form

and fax it to "Education Services" 613-993-7923.

BY MAIL

Please print and fill out this form and mail it to

The Canada Science and Technology Museum
Education Services/Reservations
P.O. Box 9724, Station T
Ottawa, Ontario K1G 5A3

BY ON-LINE FORM
*required fields

Please complete one application for each group.

School Name*
School Board
School Address
City
Province
Postal Code
Tel*	(include area code)
FAX
Teacher's Name*

Requested Date of Visit
1st Choice (Day/ Month/Year)	AM	PM
2nd Choice (Day/ Month/Year)	AM	PM

Estimated time of Arrival/Departure
Estimated time of Arrival
Estimated time of Departure

Program Choices (Please list your preference and two alternate choices)
1st
and or
2nd
and or
3rd

Total number of programs for this group:
Grade
Number of Students (maximum of 35)		Number of Chaperones
Language of Program		English French

Special Needs
Physically Challenged	yes	no	Developmentally Challenged	yes	no
ESL	yes	no	FSL	yes	no

Method of Payment	Cash Cheque
Please contact me as soon as possible regarding this matter.
Your E-mail address*

School Program Fees
(All fees are per student)

Guided School Programs: $4

Special Programs:

Curriculum Days $5

Summer Fun Days $5

Biotechnology Days $5

Self-guided programs: $2.50

SimEx Virtual Voyages™ Simulator $2

Due to space limitations, we cannot guarantee programs.
Please complete one application for each group.
Confirmation of your scheduled program will be mailed to you.

Questions about school programs should be sent to scorbeil@technomuses.ca.