Program Planning Form

Greetings from the Central Wisconsin Environmental Station! Please fill out this form completely and submit 4 weeks prior to your visit. We need this form to schedule staff, meals, and equipment. If this information is not completed and submitted by this deadline we cannot guarantee the program or time you request. Use the “Program Planning Guide” to answer questions and help you complete this form.

School Information
School Name:

Grade:

Number of students attending trip:

School Mailing Address:

School Phone Number:

School Fax Number:

Coordinator Name:

Coordinator Home Phone:

Coordinator Email Address:

Will you be attending the trip with the students?

Additional Teachers:

Additional Chaperones:

Trip #1	Trip #2	Trip #3	Trip #4
Program Dates:	Program Dates:	Program Dates:	Program Dates:

Lead Teacher:	Lead Teacher:	Lead Teacher:	Lead Teacher:

Program Type
Please select one:

Arrival Time

This information is required for completion of your schedule. (Please check with your transportation office.) Standard arrival time for an overnight group is 11:00am with a 12:00pm departure time.

Note: If you pick up and drop off groups on the same day there should only be one hour of overlap time. Arrival for group 2 is at 11 AM and departure for group 1 is at noon (after an early lunch).

Arrival Time:
Departure Time:

Programming

Wisconsin Forestree, Winter Ecology or Changing of the Land - You have chosen a unit-based educational program. No additional choices are necessary. Your students will take part in a set progression of educational activities. However, if you would prefer to make substitutions, please refer to the “A La Carte Lesson Menu” in the Program Planning Guide. Please indicate any lessons you are interested in incorporating with your program by checking the lesson below.

A la Carte - For A La Carte programs, refer to the “A La Carte Lesson Menu” in the Program Planning Guide to select a theme, related lessons, and evening programs (if applicable). Tom Quinn, the Program Manager, will contact you to discuss your options prior to your visit. Please check Pthe lessons you are interested in participating in the far left column below: