School Name*

Teacher Contact Name*

Contact Email Address*

Contact Phone Number*

School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

First Preferred Month for Program*

Second Preferred Month for Program*

Third Preferred Month for Program

Preferred Grade for Program

Total Number of Students to Participate in the Program*

Note: There is a maximum of 150 total people for Destination Cheekwood. This includes students, parents, siblings, and teachers and their families.

Is your school a Title I school?*

Please briefly explain why Destination Cheekwood is a good fit for your school. In other words, why do you want your school to participate in this program?

Destination Cheekwood

Destination Cheekwood Application