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Canada Agriculture Museum
School Programs
School Programs Reservation

School Programs Reservation

To serve you better, there are now four ways to register:

1. By phone
Please call 613-991-3053

2. By fax
Please print and fill out this form and then fax it to "Education Services" 613-993-7923.

3. By mail
Please print and fill out this form and mail it to:

4. By E-mail (on-line form)
*required fields

Please complete one application for each group.
School Name*
School Board
School Address
City
Province
Postal Code
Tel* (include area code)
FAX
Teacher's Name*

Requested Date of Visit
1st Choice (Day/ Month/Year) AM PM
2nd Choice (Day/ Month/Year) AM PM

Estimated time of Arrival/Departure
Estimated time of Arrival
Estimated time of Departure

Program Choices (Please list your preference and two alternate choices)
1st
and    or
2nd
and    or
3rd
Total number of programs for this group:
Grade
Number of Students
(maximum of 25 except for Bread Programs - maximum of 20)
Number of Chaperones
Language of Program English French

Special Needs
Physically Challenged yes no Developmentally Challenged yes no
ESL yes no FSL yes no
Method of Payment
Cash   Cheque   Debit Card
Credit Card (Visa/Master Card)

Please contact me as soon as possible regarding this matter.

Your E-mail address*

School Program Fees

$4 or $5 per student depending on program
$1 per adult (excluding teachers)

Due to space limitations, we cannot guarantee programs.
Please complete one application for each group.
Confirmation of your scheduled program will be mailed to you.

© 2006 Canada Agriculture Museum