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pdfOMB Control No. 3095-00XX
Expiration date: XX/XX/2021
The Situation Room Experience is a fully immersive, role-playing environment that will transport students into a
high-stakes, fast-paced decision-making arena as they face a national crisis based upon historical fact.
Note: All group reservations must be submitted at least 30 days prior to arrival. If you have questions, please contact [email protected].
Register Participants and Chaperones
At least 20 students are needed to run the simulation and the simulation will hold a maximum of 53 students. If you are booking more than 53 students, a member of
the education team will contact you via phone to discuss special accommodations before confirming your reservation. One chaperone is needed for every 10
students and additional adults will be required to pay the museum entrance fee. Teachers are considered adult chaperones, so count all teachers first before adding
parents! A maximum of four adults will be allowed in the Situation Room Experience. Additional adults will not be allowed in the Situation Room Experience and
should tour the museum on their own during the simulation which is three full hours.
2. Is there anything special we should know
about your student group?
1. Participant Level (select all that apply)
9th Grade Students
10th Grade Students
11th Grade Students
12th Grade Students
Undergraduate Students
Graduate Students
Other
3. Estimated Number of Students
5. Number of Parent Chaperones
4. Number of Teachers
Date and Time Selection
Correspondence will be sent to the point-of-contact within two - five business days confirming the experience date. Please select up to three preferred dates. If the
preferred dates selected are not available, alternate options will be given based on your preferences for month and year of visit.
6. Preferred Month of Visit
7. Preferred Year of Visit
8. Preferred Dates
(first choice)
(second choice)
(third choice)
Logistics of Group Visit
The Situation Room Experience is three full hours. Please plan to spend at least three hours in the simulation. Bus scholarship applications are available online at
http://situationroom.archives.gov/register. Funds are limited and scholarships are available on a first-come-first serve basis.
9. Arrival Time
10. Transportation to the museum? (select all that apply)
Bus
NATIONAL ARCHIVES AND RECORDS ADMINISTRATION
Car
Bus and Car
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11. Will you need a bus scholarship?
Yes
No
NA Form 2032 (12-16)
OMB Control No. 3095-00XX
Expiration date: XX/XX/2021
Logistics of Group Visit (cont...)
After the Situation Room Experience, participants may tour the museum and grounds and eat lunch. We encourage students to bring bag lunches which should be
left on the bus. Lunches should be in disposable paper or plastic bags, labeled with the students' names. Place ALL lunches in manageable boxes, bins or coolers
and store them under the bus. Purchasing lunch on-site is not an option for Situation Room Experience participants. We recommend allowing one and a half hours
for museum tours. Free admission for students and chaperones are included in the Situation Room Experience. One chaperone is needed for every 10 students and
additional adults will be required to pay the museum entrance fee. Teachers are considered adult chaperones, so count all teachers first before adding parents!
12. Estimated Amount of Time On-Site
13. Lunch
14. Optional Add-On
half-day
Bring Sack Lunches
Free Self-Guided Tour
full-day
No Lunch
Docent Led Tour
Information for Point of Contact
The point of contact is the primary educator responsible for organizing the logistics of the trip who will be available on-site the day of the trip to coordinate
students and chaperones and answer questions.
15. On-Site Contact First Name
16. On-Site Contact Last Name
17. On-Site Contact Mobile Number
18. On-site Contact Institution|Organization Email
Organizational Information
19. Independent Home School
20. Education Institution | Organization Name
Yes
No
21. Education Institution | Organization Mailing Address (street number and name)
22. Education Institution | Organization Mailing Address (P.O. box, suite number, et cetera)
23. City
24. State or US Territory
25. Zip Code
26. Education Institution | Organization Web Site
Alabama
27. Principal or Head of Education Institution | Organization Name (First and Last)
28. Principal or Head of Education Institution | Organization Direct Number
29. Principal or Head of Education Institution | Organization Email Address
PRIVACY ACT STATEMENT
Collection of this information is authorized by 44 U.S.C 2104. The information you provide to NARA on this form will be used to manage attendance,
registration and communication for and about NARA’s learning program. This information is necessary in order to efficiently administer the program.
Completing this form is voluntary. If you do not provide this information, NARA may not be able to process your request to participate in our education events
and distance learning opportunities. In accordance with the Privacy Act, 5 U.S.C. 552a(e)(4)(D), NARA may disclose this information to: appropriate Federal,
state, local, or foreign agencies when needed for civil, criminal, or regulatory investigations or prosecution; in response to a request from another Federal
agency or Congress; to a NARA consultant, agent, or contractor to the extent necessary for them to assist NARA in the performance of its duties; or in
accordance with any other “routine uses of records” listed in the Privacy Act System of Records Notice NARA 5, “Conference, workshop, and training course
files."
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB
control number. Public burden reporting for this collection of information is estimated to be less than 10 minutes per response. Send comments regarding
the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to National Archives and Records
Administration (MP), 8601 Adelphi Rd, College Park, MD 20740-6001. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.
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NA Form 2032 (12-16)
File Type | application/pdf |
File Title | Registration for Situation Room Experience, NA Form 2032 (12-16) |
File Modified | 2018-04-06 |
File Created | 2017-01-10 |