* mandatory field

What type of group are you ?     Elementary School Middle School High School Other *

If other please specify  

Which program would you like?     Cherokee History Chumash History General Native American Studies *

Number of students  *

Group Age/Grade:  *

Number of adults (excluding teachers)  *

Preferred date month/day/year

first choice     *

second choice

Contact Information

Contact Name *

Contact Number (###) ###-####      *

Alternative Number (###) ###-####   

E-mail     *

Location of Event

School Contact Name     *

School Name  *

School Contact Number (###) ###-####      *  

School Fax Number (###) ###-####      *  

School Address     *

 City, California, Zip     *

If different then above: 

Location Name

Address

 City, California, Zip

I have read and agree to the terms and conditions (y/n) *

Additional Information or Questions