Registration for Situation Room Experience

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Overview

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Sheet 2

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Sheet 1: Sheet1

GENERAL ADMISSION TOUR (Kennedy and GWB)

Type of group:

Select:

School

Church

Civic

Tour Group

Other _______________________

Has your group visited before?

Select:

Yes

No

Mailing Address: (City, State, Zip Code)

Fill in the blank

Daytime Phone Number:

Fill in the blank

Type of tickets requested:

Fill in the blank:

Adult _____

Senior (62+) _____

Youth (13 - 17) _____

Children (5 - 12) _____

Child (5 - 12) _____

Infant _____

Military (Retired) _____

Military (Veteran) _____

Military (Active Duty) _____

(Insert Affilliated University Name) Student, Faculty, and Staff _____

College Student (Non-Insert Affilliated University Name) _____

Questions or comment:

Fill in the blank

EDUCATION TOUR / SITUATION ROOM EXPERIENCE / BUS SCHOLARSHIP REQUEST (Kennedy, Reagan and GWB)

Confirm number participants and chaperones:

Fill in the blank:

Pre-K _____

Kindergarten _____

1st - 5th grade _____

6th - 8th grade _____

9th grade _____

10th grade _____

11th grade _____

12th grade _____

Undergraduate _____

Graduate _____

Educator _____

Chaperone _____

Parent _____

Adult _____

Participants _____

Date of visit? Select date:

What time will participants arrive for the Situation Room Experience? The Situation Room Experience is two and a half full hours. Please plan to spend at least THREE HOURS in the simulation.

Fill in the blank:

What time will participants arrive for the Situation Room Experience? The Situation Room Experience is three full hours (half-day). Please plan to spend at least FOUR HOURS in the simulation.

Fill in the blank:

What time will students arrive? Select time:

What time will participants arrive? Select time:

Self-guided Presidential Library Tour

Check the box

Docent-led Presidential Library Tour

Check the box

Select:

Museum

Special Exhibit

Park

Guided-School Program

Check the box

Museum-Educator Program

Check the box

Transportation to museum:

Select:

Bus

Car

Bus and Car

Will you need a bus scholarship?

Select:

Yes

No

We are happy to offer financial assistance. Will you be requesting funding?

Select:

Yes

No

Actual bus cost estimate:

Fill in the blank

Statement of financial need from the school principal:

Essay response

Teacher signature:

Sign and Date

Principal signature:

Sign and Date

Lunch plans:

Select:

Bring Sack-Lunches

No Lunch

Pre-order Box Lunches

Cater-in

Executive lunch plans:

Select:

No Lunch

Pre-order Box Lunches

Café & Pub

Buffet

On-site contact name: (first and last)

Fill in the blank

On-site contact cell:

Fill in the blank

On-site contact e-mail:

Fill in the blank

Independent home school:

Select:

Yes

No

Region:

Fill in the blank

School district:

Fill in the blank

Type of school:

Select:

Charter

Private

Public

Other ___________________________

Organization name:

Fill in the blank

Organization address: (street number and name, city, state, and zip code)

Fill in the blank

Organization website:

Fill in the blank

Principal or head of organization name: (first and last)

Fill in the blank

Principal or head of organization direct number:

Fill in the blank

Principal or head of organization e-mail address:

Fill in the blank

Is there anything special we should know about your group?

Fill in the blank

Do you need meeting space?

Select:

Yes

No

Field trip confirmation number:

Fill in the blank

Agenda

Fill in the blank

Pre-packet sent

Check the box

Representative submitted signed policy and use agreement.

Check the box

RESEARCH PROGRAM QUESTIONS (NYC)

Date of visit:

Fill in the blank:

1st choice: __________________

2nd choice: __________________

3rd choice: __________________

Expected time of arrival?

Fill in the blank

Duration of visit:

Fill in the blank

Number of students:

Fill in the blank

Number of educators and chaperones:

Fill in the blank

Grade level:

Fill in the blank

Type of class: (history, research, civics, language arts, other)

Fill in the blank

Location of program:

Select:

On-site

Off-site

Topic selection:

Select:

Immigration

World War II

The Bill of Rights

Inventions

Desegregation

Genealogy

Civil Rights

The New Deal

Women's Rights

Copyright

Court Cases

Labor

Prohibition

Cold War

Great Depression

Maritime

Photographs

Civil War

The Constitution

Disaster at Sea

That's Entertainment

Other ________________________________

Teacher's name:

Fill in the blank

School name:

Fill in the blank

Street address:

Fill in the blank

City:

Fill in the blank

State:

Fill in the blank

Zip code:

Fill in the blank

E-mail:

Fill in the blank

School phone number:

Fill in the blank

Cell phone to reach you if needed the day of the visit:

Fill in the blank

Would you like to receive the Education Updates Blog from the National Archives?

Select:

Yes

No

TRAVELING TRUNK PROGRAM (Reagan and GWB)

Traveling Trunks may be rented for 2 week or 4 weeks by an educator, administrator, or school district:

Select:

One week

Two Weeks

Four Weeks

Pick-up or ship:

Select:

Pick-up

Ship

Payment method:

Select:

Check

Credit Card

Payment information (name,credit card number, expiration date, security code, account number, routing number)

Fill in the blank

Billing address: (street number and name, city, state, and zip code)

Fill in the blank

Shipping address: (street number and name, city, state, and zip code)

Fill in the blank

EDUCATOR WORKSHOP QUESTIONS (Reagan)

Can you attend?

Select:

Yes, I'll be there

No, I cannot attend

Full name:

Fill in the blank

First name:

Fill in the blank

Last name:

Fill in the blank

E-mail address:

Fill in the blank

Phone number:

Fill in the blank

How many persons will attend?

Fill in the blank

What company or school are you associated with?

Fill in the blank

What is the name of the school or organization where you teach?

Fill in the blank

If you are an educator, what grade levels do you teach?

Fill in the blank

How did you hear about this event?

Fill in the blank

FILM THIS! QUESTIONS (Reagan) (ages 14 - 19)

Student Name

Fill in the blank

I am interested in attending:

Select:

Session A

Session B

Paid or Scholarship

Select:

Paid

Scholarship

Student email

Fill in the blank

Parent email

Fill in the blank

Parent Signature

Sign and Date

Student Signature

Sign and Date

Write one paragraph explaining why you would like to participate in the Reagan Student Media Seminar.

Essay response

Write one paragraph describing your experience with film and media.

Essay response

Describe your reasons for needing financial assistance.

Essay response

How much of the amount are you able to pay?

Essay response

Which session would you prefer?

Essay response

ONLINE / DISTANCE LEARNING QUESTIONS (Reagan)

What are the names of people attending webinar?

Fill in the blank

What is your school name and field trip date?

Fill in the blank

Which session date do you plan to attend?

Date is selected from a drop down menu of options.

What is your email address?

Fill in the blank

PROFESSIONAL DEVELOPMENT WEBINAR (Archives 1 and Seattle)

Teacher Name

Fill in the blank

Title

Fill in the blank

Phone Number

Fill in the blank

Education Institution/Organization Name

Fill in the blank

Address 1

Fill in the blank

Address 2

Fill in the blank

City

Fill in the blank

State

Fill in the blank

Zip

Fill in the blank

Select a Distance Learning Program

National History Day & Online Catalog

Using & Creating DocsTeach Activities

Bringing Native American Voices into your Classroom

Select a Time Zone

Alaska Standard Time

Atlantic Standard Time

Central Standard Time

Eastern Standard Time

Hawaiin-Aleutian Standard Time

Mountain Standard Time

Pacific Standard Time

Connection Preference

Select:

Webcam/Computer/Desktop Web Conferencing Software

Traditional Video Conferencing Equipment/IP (H.323) Connection

Unsure

Preferred Date 1

Fill in the blank

Preferred Time 1

Fill in the blank

Preferred Date 2

Fill in the blank

Preferred Time 2

Fill in the blank

Preferred Date 3

Fill in the blank

Preferred Time 3

Fill in the blank

Number of Participants

Fill in the blank

Occupation

Fill in the blank

Grade Level

Select:

K-2

3-5

6-8

9-12

Higher Education

Other

Special Accommodations

Select:

Yes

No

Space to write in any special accommodations.

Comment or Questions

Space to write in any comments or questions.

Connect with the National Archives

Would you like to receive emails about new teaching tools, lesson plans, online activities, field trips, professional development, and primary sources our Education Updates Blog?

Select:

Yes

No

Would you like to receive emails about upcoming distance learning programs?

Select:

Yes

No

K-12 DISTANCE LEARNING PROGRAMS (Archives 1 and Fort Worth)

Teacher Name

Fill in the blank

Title

Fill in the blank

Phone Number

Fill in the blank

Education Institution/Organization Name

Fill in the blank

Address 1

Fill in the blank

Address 2

Fill in the blank

City

Fill in the blank

State

Fill in the blank

Zip

Fill in the blank

Select a K-12 Distance Learning Program

Our Classroom Bill of Rights (For Grades K-2)

Superhero Bill of Rights (For Grades 3-5)

The Bill of Rights in Real Life (For Grades 6-8)

Know Your Rights (For Grades 9-12)

Select a Time Zone

Alaska Standard Time

Atlantic Standard Time

Central Standard Time

Eastern Standard Time

Hawaiin-Aleutian Standard Time

Mountain Standard Time

Pacific Standard Time

Connection Preference

Select:

Webcam/Computer/Desktop Web Conferencing Software

Traditional Video Conferencing Equipment/IP (H.323) Connection

Unsure

Preferred Date 1

Fill in the blank

Preferred Time 1

Fill in the blank

Preferred Date 2

Fill in the blank

Preferred Time 2

Fill in the blank

Preferred Date 3

Fill in the blank

Preferred Time 3

Fill in the blank

Number of Participants

Fill in the blank

Number of Students

Fill in the blank

Grade Level

Select:

K

1

2

3

4

5

6

7

8

9

10

11

12

Type of Class (U.S. History, Civics, Language Arts, etc.)

Fill in the blank

Special Accommadations

Select:

Yes

No

Space to write in any special accommadations.

Comment or Questions

Space to write in any comments or questions.

Connect with the National Archives

Would you like to receive emails about new teaching tools, lesson plans, online activities, field trips, professional development, and primary sources our Education Updates Blog?

Select:

Yes

No

Would you like to receive emails about upcoming distance learning programs?

Select:

Yes

No

PRIMARILY TEACHING

Name

Fill in the blank

Phone Number

Fill in the blank

Title

Fill in the blank

Email Address

Fill in the blank

Education Institution/Organization Name

Fill in the blank

Home Mailing Address 1

Fill in the blank

Home Mailing Address 2

Fill in the blank

City

Fill in the blank

State

Fill in the blank

Zip

Fill in the blank

School Name

Fill in the blank

School City

Fill in the blank

School State

Fill in the blank

School Zip

Fill in the blank

Research Interest

Select a NARA Location (Dates of Primarily Teaching will be dictated by respective location.)

Select from drop down options.

Research Interest (Your topic of independent research must use original records among the holdings of the National Archives. Keeping the guidelines from the workshop overview in mind, identify and independent research topic of interest to you. Be as specific as possible. You may choose to continue independent research on the case study.

Space to write in research interest.

Primarily Teaching Application Agreement

I have read and agree to the Primarily Teaching Application.

Select:

Yes

No

Would you like to receive emails about new teaching tools, lesson plans, online activities, field trips, professional development, and primary sources our Education Updates Blog?

Select:

Yes

No

Would you like to receive emails about upcoming distance learning programs?

Select:

Yes

No

LEARNING LAB REGISTRATION (ARCHIVES 1)

Teacher's Name

Fill in the blank

Title

Fill in the blank

Email

Fill in the blank

Phone Number

Fill in the blank

Cell Phone Number (Required for Day of Visit)

Fill in the blank

Fax Number

Fill in the blank

School Name

Fill in the blank

Address 1

Fill in the blank

Address 2

Fill in the blank

City

Fill in the blank

State

Fill in the blank

Zip

Fill in the blank

Preferred Date 1

Fill in the blank

Select a Program Time and Time 1

Select:

Constitution in Action Lab-One Session 10:00 a.m.-12:00 p.m.

Constitution in Action Lab-One Session 12:30 p.m.-2:30 p.m.

Constitution in Action Lab-Two Sessions (in rotation from 9:50 a.m. to 2:30 p.m.)

The Civil War: Celebrate or Commemorate?-One Session 11:00 a.m.-12:00 p.m.

The Civil War: Celebrate or Commemorate?-One Session 12:30 p.m.-1:30 p.m.

The Civil War: Celebrate or Commemorate?-One Session 2:00 p.m.-3:00 p.m.

The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 10:50 a.m. to 1:30 p.m.)

The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 12:20 p.m. to 3:00 p.m.)

The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 10:50 a.m. to 3:00 p.m.)

Rights and Responsibilities-One Session 11:00 a.m. -12:00 p.m.

Rights and Responsibilities-One Session 12:30 p.m. -1:30 p.m.

Rights and Responsibilities-One Session 2:00 p.m. -3:00 p.m.

Rights and Responsibilities-Two Sessions (in rotation from 10:50 a.m. to 1:30 p.m.)

Rights and Responsibilities-Two Sessions (in rotation from 12:20 p.m. to 3:00 p.m.)

Rights and Responsibilities-Two Sessions (in rotation from 10:50 a.m. to 3:00 p.m.)

Preferred Date 2

Fill in the blank

Select a Program Time and Time 2

See options to select from under: Select a Program Time and Time 1

Preferred Date 3

Fill in the blank

Select a Program Time and Time 3

See options to select from under: Select a Program Time and Time 1

Number of Students

Fill in the blank

Number of Teachers

Fill in the blank

Number of Other Chaperones (We ask that there be one chaperone for every 10 students.)

Fill in the blank

Total Number of Attendees

Fill in the blank

Grade Level

Select:

K

1

2

3

4

5

6

7

8

9

10

11

12

Type of Class (U.S. History, Civics, Language Arts, etc.)

Fill in the blank

Special Needs Accommodations

Select:

Yes

No

Space to write in any special accommadations.

Applicant Agreement

Check:

I have read and agree to the terms of the Pre-Visit Preparation and Requirements, and my students will be prepared for their visit. I understand I may bring no more than 36 students per lab session.

Visits to the Rotunda and other exhibition areas are not part of the lab experience. I must allow more time if I want my students to visit these spaces.

Would you like to receive emails about new teaching tools, lesson plans, online activities, field trips, professional development, and primary sources our Education Updates Blog?

Select:

Yes

No

Would you like to receive emails about upcoming distance learning programs?

Select:

Yes

No

GROUP TOUR AND FIELD TRIP RESERVATIONS (LBJ)

Group Type

Are you a:

Select:

Pre-K-12 Group

College/University Group

General Group

[Pre-K-12] Tell Us About Your Visit

Name of School or Group

Fill in the blank

Name of Tour Company (if applicable)

Fill in the blank

Preferred Visit Date

Fill in the blank

Alternative Visit Date

Fill in the blank

If you are planning to visit over the course of multiple days, please indicate below. Number of Students (15 minimum, 60 maximum)

Fill in the blank

Grade Level(s)

Fill in the blank

Ages of Students

Fill in the blank

Number of School Staff. Please include bus driver(s) and/or coordinator.

Fill in the blank

Number of Other Adult Chaperones

Fill in the blank

How would you like to spend your time at the library? (?) Our immersive classroom experiences take place in the Lady Bird Education Center, located on the second floor of the LBJ Library. Each experience is hands-on giving students the opportunity to work with our primary resources from our archives or with artifacts from our museum collection.

Guided tour, no immersive classroom experience

Preferred Start Time

Select:

9:30 a.m.

11:30 a.m.

1:30 p.m.

2:30 p.m.

Alternative Start Time

Fill in the blank

Preferred Length of Tour (Min. time: 60 minutes, Typical tour is 90 minutes)

Fill in the blank

Guided tour with immersive classroom experience

Preferred Start Time

Select:

9:30 a.m.

11:30 a.m.

1:30 p.m.

Which immersive classroom experience would you like to participate in? A tour is included with each experience.Note(s): 1) The tour portion of your visit is self-guided. The classroom experience is facilitated and led by an LBJ Library Education Specialist. 2) Please visit our Education page to learn more about each of our experiences.

Dropdown:

The Spy's Dilemma/LBJ and the Cold War Program and Tour (2.5-3 hours)

Vietnam: A Presidential Decision Program and Tour (3-4 hours) A

Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours)

A Matter of Civil Rights Program and Tour (2 hours)

Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours)

Election Collection Program and Tour (2-2.5 hours)

Self-guided tour, no immersive classroom experience

Preferred Start Time Please select a time between 9:30 a.m.-3:30 p.m.

Fill in the blank

Alternative Start Time

Fill in the blank

Preferred Length of Tour (Min. time: 60 minutes, Typical tour is 90 minutes)

Fill in the blank

Self-guided tour with immersive classroom experience

Preferred Start Time Please select a time between 9:30 a.m.-3:30 p.m.

Fill in the blank

Which immersive classroom experience would you like to participate in? A tour is included with each experience.Please visit our Education page to learn more about each of our experiences.Self-guided tour with immersive classroom experience

Dropdown:

The Spy's Dilemma/LBJ and the Cold War Program and Tour (2.5-3 hours)

Vietnam: A Presidential Decision Program and Tour (3-4 hours) A

Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours)

A Matter of Civil Rights Program and Tour (2 hours)

Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours)

Election Collection Program and Tour (2-2.5 hours)

College/University Group

Name of School or Group

Fill in the blank

Name of Tour Company (if applicable)

Fill in the blank

Preferred Visit Date

Fill in the blank

Alternative Visit Date

Fill in the blank

If you are planning to visit over the course of multiple days, please indicate below.

Fill in the blank

Number of Students (60 maximum)

Fill in the blank

Number of faculty/staff and bus driver(s)

Fill in the blank

How would you like to spend your time at the library?

Immersive classroom experience only, no tour

Which immersive classroom experience would you like to participate in?Please visit our Education page to learn more about each of our experiences.

Dropdown:

Vietnam: A Presidential Decision Program and Tour (3-4 hours) A

Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours)

A Matter of Civil Rights Program and Tour (2 hours)

Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours)

Introduction to Holdings and Tour (2 - 3 hours)

Guided tour, no immersive classroom experience

Preferred Tour Start Time

Select:

9:30 a.m.

11:30 a.m.

1:30 p.m.

2:30 p.m.

Alternative Start Time

Fill in the blank

Preferred Length of Tour (typical tour is 90 minutes)

Fill in the blank

Guided tour, with immersive classroom experience

Preferred Tour Start Time

Select:

9:30 a.m.

11:30 a.m.

1:30 p.m.

Which immersive classroom experience would you like to participate in?Please visit our Education page to learn more about each of our experiences.

Dropdown:

Vietnam: A Presidential Decision Program and Tour (3-4 hours) A

Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours)

A Matter of Civil Rights Program and Tour (2 hours)

Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours)

Introduction to Holdings and Tour (2 - 3 hours)

Self-guided tour, no immersive classroom experience

Preferred Start Time Please select a time between 9:30 a.m.-3 p.m.

Fill in the blank

Alternative Start Time

Fill in the blank

Preferred Length of Tour (typical tour is 90 minutes)

Fill in the blank

Self-guided tour with immersive classroom experience

Preferred Start Time Please select a time between 9:30 a.m.-3 p.m.

Fill in the blank

Which immersive classroom experience would you like to participate in? A tour is included with each experience.Note(s): 1) The tour portion of your visit is self-guided. The classroom experience is facilitated and led by an LBJ Library Education Specialist. 2) Please visit our Education page to learn more about each of our experiences.

Dropdown:

Vietnam: A Presidential Decision Program and Tour (3-4 hours) A

Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours)

A Matter of Civil Rights Program and Tour (2 hours)

Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours)

Introduction to Holdings and Tour (2 - 3 hours)

General Group or Contact Information

Name of Group

Name of Tour Company (if applicable)

Fill in the blank

Preferred Visit Date

Fill in the blank

Alternative Visit Date

Fill in the blank

If you are planning to visit over the course of multiple days, please indicate below.

Fill in the blank

Friendly reminder: We do not offer guided tours for non-school groups. For more information, please contact the Volunteer and Visitor Services Office at (512) 721-0184.

What is your preferred start time?Self-guided tours are available between 9:30 a.m.-3:30 p.m.

Fill in the blank

Alternative Start Time We ask for an alternative arrival time in case many self-guided tours are booked on the day of your visit. We want to ensure your group is accommodated and that your visit is pleasant.

Fill in the blank

Preferred Length of Tour (Min. time: 60 minutes, Typical tour is 90 minutes)

Fill in the blank

Tell us about your group.

This will help us efficiently check you in on your day of visit.

Number of Tour Director(s) or Group Leader(s) and Bus Driver(s) (Free admission)

Fill in the blank

Number of Adults (Admission $7)

Fill in the blank

Number of Seniors (Admission $5)

Fill in the blank

Number of Youth (13-17) (Admission $3)

Fill in the blank

Number of Children (12 and under) (Free admission)

Fill in the blank

Number of Non-UT Austin College/University Students (Admission $3)

Fill in the blank

Number of UT Austin Students, Staff, and Faculty (Free admission)

Fill in the blank

Number of Active Duty Military (Free admission)

Fill in the blank

Number of Former Military (Admission $5)

Fill in the blank

Number of LBJ Library Members and Other NARA Presidential Library Members (Free admission)

Fill in the blank

Main Contact First Name

Fill in the blank

Main Contact Last Name

Fill in the blank

Main Contact Person Title:

Fill in the blank

Email Address

Fill in the blank

Phone Number (Direct line or cell phone preferred)

(XXX) XXX-XXXX

Street Address

Fill in the blank

Address Line 2

Fill in the blank

City

Fill in the blank

State

Drop down list of every U.S. state

Zip Code

Fill in the blank

On the day of your visit, will there be a different point of contact?

Select:

Yes

No

Day-of Contact First Name:

Fill in the blank

Day-of Contact Last Name: Day-of Contact Email Address

Fill in the blank

Day-of Contact Phone Number (Cell phone preferred)

Fill in the blank

Additional Information

Additional CommentsInclude any specific day-of needs, ADA accommodations, or more

Fill in the blank

If you have been in touch with a specific LBJ Library contact, please include their name below:

Fill in the blank

Would your group like to visit our museum store—The Store at LBJ?

Select:

Yes

No

LIBRARY QUESTIONS (Kennedy)

Have you ever visited the museum?

Fill in the blank

Have you brought students for a guided program? (Which one?)

Fill in the blank

How did you learn about this program?

Fill in the blank

Will you (briefly) indicate how the visit relates to your school curriculum?

Fill in the blank

Confirm number participants and chaperones:

Fill in the blank:

Pre-K _____

K - 2nd _____

3rd - 5th grade _____

6th - 8th grade _____

9th grade _____

10th grade _____

11th grade _____

12th grade _____

Undergraduate _____

Graduate _____

Educator _____

Chaperone _____

Parent _____

Adult _____

Participants _____

We are happy to work with you to provide reasonable accommodations for students. Please let us know how we can support you.

Fill in the blank

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Sheet 2: Sheet 2

Actual bus cost estimate:
Address 1
Address 2
Home Mailing Address 1
Home Mailing Address 2
Mailing Address: (City, State, Zip Code)
Organization address: (street number and name, city, state, and zip code)
Street address:
Applicant Agreement: Check: I have read and agree to the terms of the Pre-Visit Preparation and Requirements, and my students will be prepared for their visit. I understand I may bring no more than 36 students per lab session. Visits to the Rotunda and other exhibition areas are not part of the lab experience. I must allow more time if I want my students to visit these spaces.
Can you attend? Yes, I'll be there No, I cannot attend
Cell Phone Number (Required for Day of Visit)
Cell phone to reach you if needed the day of the visit:
Day-of Contact Phone Number (Cell phone preferred)
City
Comment or Questions
Connection Preference: Webcam/Computer/Desktop Web Conferencing Software Traditional Video Conferencing Equipment/IP (H.323) Connection
Date of visit? or Date of visit: Fill in the blank or Select date
Preferred Date 1
Preferred Date 2
Preferred Date 3
Preferred Time 1
Preferred Time 2
Preferred Time 3
Preferred Visit Date
Alternate Visit Date
If you are planning to visit over the course of multiple days, please indicate below. Number of Students (15 minimum, 60 maximum)
Preferred Length of Tour (Min. time: 60 minutes, Typical tour is 90 minutes)
Preferred Start Time Please select a time between 9:30 a.m.-3:30 p.m.
Daytime Phone Number:
Phone Number
Phone Number (Direct line or cell phone preferred)
Describe your reasons for needing financial assistance.
Do you need meeting space? Yes No
Docent-led Presidential Library Tour: Museum Special Exhibit Park
Duration of visit:
E-mail address or Email address:
E-mail or email:
What is your email address?
Education Institution/Organization Name
Organization name:
What is the name of the school or organization where you teach?
What is your school name and field trip date?
Name of School or Group
Name of Tour Company (if applicable)
School name:
What company or school are you associated with?
Executive lunch plans: No Lunch Pre-order Box Lunches Café & Pub Buffet
Lunch plans: Bring Sack-Lunches No Lunch Pre-order Box Lunches Cater-in
Expected time of arrival?
Fax Number
Field trip confirmation number:
First name:
Full name:
Last name:
Name
Grade level: K 1 2 3 4 5 6 7 8 9 10 11 12
Grade level(s): Fill in the blank
Age of Student
If you are an educator, what grade levels do you teach?
Guided-School Program Check the box
Has your group visited before?
Have you brought students for a guided program? (Which one?)
Have you ever visited the museum?
How did you hear about this event?
How did you learn about this program?
How many persons will attend?
How much of the amount are you able to pay?
How would you like to spend your time at the library? (?) Our immersive classroom experiences take place in the Lady Bird Education Center, located on the second floor of the LBJ Library. Each experience is hands-on giving students the opportunity to work with our primary resources from our archives or with artifacts from our museum collection.
I am interested in attending: Session A Session B
I have read and agree to the Primarily Teaching Application. Yes No
If you have been in touch with a specific LBJ Library contact, please include their name below:
Independent home school: Yes No
Is there anything special we should know about your group?
Location of program: On-site Off-site
Museum-Educator Program Check the box
Confirm number participants and chaperones: Pre-K _____ K - 2nd _____ 3rd - 5th grade _____ 6th - 8th grade _____ 9th grade _____ 10th grade _____ 11th grade _____ 12th grade _____ Undergraduate _____ Graduate _____ Educator _____ Chaperone _____ Parent _____ Adult _____ Participants _____ or Pre-K _____ Kindergarten _____ 1st - 5th grade _____ 6th - 8th grade _____ 9th grade _____ 10th grade _____ 11th grade _____ 12th grade _____ Undergraduate _____ Graduate _____ Educator _____ Chaperone _____ Parent _____ Adult _____ Participants _____
Number of educators and chaperones:
Number of Other Chaperones (We ask that there be one chaperone for every 10 students.)
Number of faculty/staff and bus driver(s)
Number of Participants
Number of Students
Number of Students (60 maximum)
Number of Teachers
What are the names of people attending webinar?
Number of School Staff. Please include bus driver(s) and/or coordinator.
Number of Other Adult Chaperones
Number of Tour Director(s) or Group Leader(s) and Bus Driver(s) (Free admission)
Number of Adults (Admission $7)
Number of Seniors (Admission $5)
Number of Youth (13-17) (Admission $3)
Number of Children (12 and under) (Free admission)
Number of Non-UT Austin College/University Students (Admission $3)
Number of UT Austin Students, Staff, and Faculty (Free admission)
Number of Active Duty Military (Free admission)
Number of Former Military (Admission $5)
Number of LBJ Library Members and Other NARA Presidential Library Members (Free admission)
Occupation
On-site contact cell:
On-site contact e-mail:
On-site contact name: (first and last)
Day-of Contact First Name:
Day-of Contact Last Name:
Day-of Contact Email Address
Day-of Contact Phone Number (Cell phone preferred)
Main Contact First Name
Main Contact Last Name
Main Contact Person Title:
Organization website:
On the day of your visit, will there be a different point of contact? Yes No
Paid or Scholarship: Paid Scholarship
Parent email
Parent Signature
Payment information (name,credit card number, expiration date, security code, account number, routing number)
Payment method: Check Credit Card
Billing address: (street number and name, city, state, and zip code)
Shipping address: (street number and name, city, state, and zip code)
Pick-up or ship: Pick-up Ship
Principal or head of organization direct number:
Principal or head of organization e-mail address:
Principal or head of organization name: (first and last)
Principal signature:
Questions or comment:
Region:
Research Interest (Your topic of independent research must use original records among the holdings of the National Archives. Keeping the guidelines from the workshop overview in mind, identify and independent research topic of interest to you. Be as specific as possible. You may choose to continue independent research on the case study. Space to write in research interest.
School city:
School district:
School phone number:
School state
School zip
Select a Distance Learning Program: National History Day & Online Catalog Using & Creating DocsTeach Activities Bringing Native American Voices into your Classroom
Select a K-12 Distance Learning Program Our Classroom Bill of Rights (For Grades K-2) Superhero Bill of Rights (For Grades 3-5) The Bill of Rights in Real Life (For Grades 6-8) Know Your Rights (For Grades 9-12)
Select a NARA Location (Dates of Primarily Teaching will be dictated by respective location.) Select from drop down options.
Select a Program Time and Time 1 Constitution in Action Lab-One Session 10:00 a.m.-12:00 p.m. Constitution in Action Lab-One Session 12:30 p.m.-2:30 p.m. Constitution in Action Lab-Two Sessions (in rotation from 9:50 a.m. to 2:30 p.m.) The Civil War: Celebrate or Commemorate?-One Session 11:00 a.m.-12:00 p.m. The Civil War: Celebrate or Commemorate?-One Session 12:30 p.m.-1:30 p.m. The Civil War: Celebrate or Commemorate?-One Session 2:00 p.m.-3:00 p.m. The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 10:50 a.m. to 1:30 p.m.) The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 12:20 p.m. to 3:00 p.m.) The Civil War: Celebrate or Commemorate?-Two Sessions (in rotation from 10:50 a.m. to 3:00 p.m.) Rights and Responsibilities-One Session 11:00 a.m. -12:00 p.m. Rights and Responsibilities-One Session 12:30 p.m. -1:30 p.m. Rights and Responsibilities-One Session 2:00 p.m. -3:00 p.m. Rights and Responsibilities-Two Sessions (in rotation from 10:50 a.m. to 1:30 p.m.) Rights and Responsibilities-Two Sessions (in rotation from 12:20 p.m. to 3:00 p.m.) Rights and Responsibilities-Two Sessions (in rotation from 10:50 a.m. to 3:00 p.m.)
Select a Program Time and Time 2 See options to select from under: Select a Program Time and Time 1
Select a Program Time and Time 3 See options to select from under: Select a Program Time and Time 1
Select a Time Zone Alaska Standard Time Atlantic Standard Time Central Standard Time Eastern Standard Time Hawaiin-Aleutian Standard Time Mountain Standard Time Pacific Standard Time
Self-guided Presidential Library Tour
Special Accommodations Yes No
Special Needs Accommodations Yes No Space to write in any special accommadations.
Additional Comments Include any specific day-of needs, ADA accommodations, or more
State:
Statement of financial need from the school principal:
Student email
Student Name
Student Signature
Teacher Name or Teacher's name
Teacher signature:
Title
Topic selection: Immigration World War II The Bill of Rights Inventions Desegregation Genealogy Civil Rights The New Deal Women's Rights Copyright Court Cases Labor Prohibition Cold War Great Depression Maritime Photographs Civil War The Constitution Disaster at Sea That's Entertainment Other ________________________________
Total Number of Attendees
Transportation to museum: Bus Car Bus and Car
Traveling Trunks may be rented for 2 week or 4 weeks by an educator, administrator, or school district: One week Two Weeks Four Weeks
Type of class (U.S. History, Civics, Language Arts, etc.)
Type of class: (history, research, civics, language arts, other)
Group Type: Are you a: Pre-K-12 Group College/University Group General Group
Type of group: School Church Civic Tour Group Other _______________________
Type of school: Charter Private Public Other ___________________________
Type of tickets requested: Adult _____ Senior (62+) _____ Youth (13 - 17) _____ Children (5 - 12) _____ Child (5 - 12) _____ Infant _____ Military (Retired) _____ Military (Veteran) _____ Military (Active Duty) _____ (Insert Affilliated University Name) Student, Faculty, and Staff _____ College Student (Non-Insert Affilliated University Name) _____
We are happy to offer financial assistance. Will you be requesting funding? Yes No
We are happy to work with you to provide reasonable accommodations for students. Please let us know how we can support you.
What time will participants arrive for the Situation Room Experience? The Situation Room Experience is three full hours (half-day). Please plan to spend at least FOUR HOURS in the simulation.
What time will participants arrive for the Situation Room Experience? The Situation Room Experience is two and a half full hours. Please plan to spend at least THREE HOURS in the simulation.
What time will participants arrive? Select time:
What time will students arrive? Select time:
Which session date do you plan to attend? Date is selected from a drop down menu of options.
Which session would you prefer?
Which immersive classroom experience would you like to participate in? A tour is included with each experience.Note(s): 1) The tour portion of your visit is self-guided. The classroom experience is facilitated and led by an LBJ Library Education Specialist. 2) Please visit our Education page to learn more about each of our experiences. The Spy's Dilemma/LBJ and the Cold War Program and Tour (2.5-3 hours) Vietnam: A Presidential Decision Program and Tour (3-4 hours) A Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours) A Matter of Civil Rights Program and Tour (2 hours) Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours) Election Collection Program and Tour (2-2.5 hours)
Which immersive classroom experience would you like to participate in? A tour is included with each experience. Please visit our Education page to learn more about each of our experiences.Self-guided tour with immersive classroom experience. The Spy's Dilemma/LBJ and the Cold War Program and Tour (2.5-3 hours) Vietnam: A Presidential Decision Program and Tour (3-4 hours) A Civil Rights Investigation: Mississippi Burning Program and Tour (1-1.5 hours) A Matter of Civil Rights Program and Tour (2 hours) Great Society Program and Tour (2-3 hours) Election Collection Program and Tour (2-2.5 hours) Election Collection Program and Tour (2-2.5 hours)
Will you (briefly) indicate how the visit relates to your school curriculum?
Will you need a bus scholarship? Yes No
Would you like to receive emails about new teaching tools, lesson plans, online activities, field trips, professional development, and primary sources our Education Updates Blog? Yes No
Would you like to receive emails about upcoming distance learning programs? Yes No
Would you like to receive the Education Updates Blog from the National Archives? Yes No
Would your group like to visit our museum store—The Store at LBJ?
Write one paragraph describing your experience with film and media.
Write one paragraph explaining why you would like to participate in the Reagan Student Media Seminar.
Zip or Zip Code