BAM Education Waitlist Form

What performance or screening would you like to attend?*

Select or enter value

School Liaison Name:*

School Liaison Title:*

School Liaison Email Address:*

School Liaison Phone Number:*

Name of School:*

School District:*

School Address:*

(Street, City, State, & Zip)

School Telephone:*

Are you a Title I School?*

Select or enter value

Has your school booked a school-time field trip to BAM before?

Select or enter value

How did you hear about this program?

What grade levels will be participating?*

(ie. 1st, 9th – 12th)

Total student seats requested:*

Total adult seats requested:*

How will your school be traveling to BAM?

Do any of your students request special assistance getting into our venue?

Yes / No If yes, explain:

Included in your reservation is a free pre-show workshop with a BAM Teaching Artist for each class of students attending the event. The following information will help BAM Education arrange these workshops for your students.

Total # of participating classes to receive pre-show prep workshops:*

Total size of each participating class:*

Please list the days and times that each class meets when an in-school workshop could take place:*

Ex - Class 1: Tuesdays/Thursdays, 2:00-2:45pm. Class 2: Monday/Wednesdays, 9:15-10:00am

School Contact Name (who can coordinate the scheduling of these workshops), if different from above:

School Contact Email Address (if different from above):

School Contact Phone Number (if different from above):

Are there any special considerations your BAM Teaching Artist should know about? (eg. ELL, Special Needs, etc) If so, please explain.

By submitting this form I understand that our school is registering for an education film screening or performance which will include a pre-show prep workshop and post-show Q&A.

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