Online Reservation Request for Junior Science Academy

Thank you for using the UMNH Online Reservation Request System for the Junior Science Academy program.

Complete the form noting the class you prefer, desired date and time and the required contact information. You will receive acknowledgement of your request via email within 24 hours. All requests made before September 30, 2009 will be processed by October 1, 2009. Requests made after October 1, 2009 will be processed within 5 business days. In either case, if your desired class and date can be accommodated, we will email you a confirmation receipt. If your request cannot be accommodated, we will contact you using the phone and email address provided.

Please note: A request does not guarantee placement within the program.

Also, each class MUST schedule their own visit as we can only accommodate one class (maximum of 25 students) per time slot.

For further information or help with the Online Reservation System, email jsa@umnh.utah.edu or call 801-581-6286.

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Junior Science Academy Reservation Request Form

First Name:

Last Name:

Your Email:

Alternate Email:

School Type:

If school type other please explain:

School District:

School:

Address:

City:

State:

Zip Code:

Phone:

Alternate Phone:

UMNH requires 1 adult chaperone per 8 visitors under age 16.

Grade:

If other please explain:

Topic:

Number of Teachers:

Number of Students:

Number of Chaperones:

Preferred Visit Date

First Choice:

Preferred Time 1:

Second Choice:

Preferred Time 2:

Additional Comments or Questions:

Would you like to receive email news about UMNH programs and events?

Yes		No

You are requesting:

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