Program Application for Nature Programs

Today's Date*

Program tracking information

Please tell us the type of program you are applying for and the age category of the participants. This information is used internally for tracking purposes.

What type of program are you applying for?*

Ladybug Nature Walk (ages 2-6)

Nature-based field trip (for K-12 students)

Custom Nature Program (all ages & abilities)

How did you hear about our nature education program?*

Select or enter value

Information about your school, organization, group, or club

School or Organization - Name*

School or Organization - Phone*

Phone

School or Organization - Street Address (Number and Street)*

School or Organization - City*

School or Organization - Zip Code*

Are you a Title I or federally-funded school?*

Yes

No

Information about program topic, location, and participants

If you said the topic was "not listed here", please tell us the topic you would like to explore.

Please give us any additional information about the topic you selected.

Are you hoping we cover something specific to complement classroom learning? Are you hoping to modify the topic in some way? Did you suggest a topic that was not on the list? Please give us any details.

Where would you like your program to take place?*

All programs need to take place in a Portland park or natural area. Urban Nature Exploration field trips can take place in any neighborhood park or natural area. If you aren't sure what to choose, pick "I'm not sure" and we will help you decide.

Select

Number of student participants*

Please give us the estimated maximum number as if every child or youth will participate.

Number of adult chaperones*

We recommend a ratio of one adult for every six students attending the field trip, not including the teacher.

Please tell us the grade level of the participants.*

Choose all that apply

Select

Do any of your participants require special accommodations to participate?*

Yes

No

Two educators can lead bilingual Spanish-English nature programs. Does your group have Spanish speakers? Would you like to have one or more groups that are bilingual?

Please tell us how your participants will arrive to the program.*

Choose all that apply. If your option is not listed, simply write it in.

Select or enter value

Program dates, start times, and cost per participant

Before requesting dates, please check the calendar to make sure they are available. Many dates are already filled!

https://www.portland.gov/parks/environmental-education/available-dates

We are able to accommodate two programs with the same school or organization in one day as long as our staff is guaranteed a 30-minute lunch break. If your group size is larger than 30 or there are two classes wanting to join on the same day, this will be the best option. (Note: This may require that you occupy half the group while our staff works with the other half.)

What is your first choice date for the program?*

We are available for programs Tuesday through Friday and some weekends if staff capacity allows.

First choice date - start time*

Scroll down the list to find morning times, afternoon times, and options for having two programs in the same day.

Select or enter value

What is your second choice date for the program?*

We are available for programs Tuesday through Friday and some weekends if staff capacity allows.

Second choice date - start time*

Scroll down the list to find morning times, afternoon times, and options for having two programs in the same day.

Select or enter value

What is your third choice date for the program?*

We are available for programs Tuesday through Friday and some weekends if staff capacity allows.

Third choice date - start time*

Scroll down the list to find morning times, afternoon times, and options for having two programs in the same day.

Select or enter value

Cost for the program - Please choose your fee based on the following choices:*

$1/participant - Title I Schools (receiving federal funds) $5/participant - Non-Title I Schools/Organizations $7/participant - Schools/Organizations who can pay for themselves + donate $2 to help cover the cost for a school who cannot afford the fee.

Select

Fee Reduction Request Form

If you are unable to pay your listed cost of the field trip, please fill out the form at https://www.portland.gov/parks/environmental-education/field-trips#toc-fee-reduction-option

Drag and drop files here or

Information about the primary and alternate contacts

Please give us information about who is planning the program for the school or organization.

Primary Contact - Last Name*

Primary Contact - First Name*

Primary Contact - Pronouns*

What pronouns do you use?

Select or enter value

What is your relationship to the participants?*

If your relationship is not listed, please write it in.

Select or enter value

Primary Contact - Email*

Primary Contact - Cell phone*

Phone

Alternate Contact - Last Name*

Please give us an additional contact at your school or organization in the event something comes up and we cannot contact you.

Alternate Contact - First Name*

Alternate Contact - Email*

Alternate Contact - Cell phone*

Phone

Who is the best person to contact on the day of the program?*

First and last name

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