Schedule a VisitPlease fill-out the form below and someone will contact you shortlyFields marked with an * are required. School DetailsFair DetailsEvent DetailsRequest TypeSchoolFairEducational ProgramOtherSchool/Event Physical Location County of School/EventName of School Name of SchoolSchool District School Principal’s Name Name of FairEvent Contact InformationCheck this box if your mailing address is the same as the physical address listed aboveMailing Address (If different than physical address) Contact Person Position Contact EmailThis should be your primary email address (your school email address, if this is a school visit) Secondary EmailNote: Please provide a secondary (non-school) email address due to school email security issues Phone Number Cell Number After-hours/Emergency Phone # How did you hear about us? If “Other”, please specify below:Please indicate four choices of dates and time that will work:Please indicate event start and end dates:We will try our best to accommodate you on one of these dates. Click input to select a date from the calendar Click input to select a date from the calendar Click input to select a date from the calendar Click input to select a date from the calendarEvent Start and End Dates: to Desired starting time for presentation:123456789101112:000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 ampm PST (UTC -8:00)MST (UTC -7:00)CST (UTC -6:00)EST (UTC -5:00)Enrollment DataAll fields are required. However, if you do not know the number of students or classes, you may leave the field blank or enter the number zero (0).If you do not know the individual breakdown of students and/or classes, please enter the total number of students and classes in the "Totals" row.Grade# of Students# of ClassesK:1st:2nd:3rd:4th:5th:6th:7th:8th:9th:10th:11th:12th:Totals:Audience DetailsExpected General Public Attendance:Expected Attendance: Expected Scheduled Children Attendance: Houston Schools Nutrition Education ClassBecause you are in the Houston School District, you have the opportunity to take place in an optional Nutrition Education Class. If you would like more information about this optional class, please check the box below.Yes, I would like to receive information regarding the Nutrition Education class.Please acknowledge agreement to the following conditions:I understand the physical requirements for the 36-foot trailer Classroom and will be able to provide the necessary arrangements for accommodations. For more detailed information about physical requirements, please visit this page.I further understand that the Mobile Dairy Classroom is an educational program and agree to instruct the students and faculty that excellent behavior is expected.
