Visiting Naturalist in the Schools Registration Form 2022-2023 Visiting Naturalist in the Schools Program Registration Lead Teacher Name * Lead Teacher Name First First Last Last Lead Teacher Email * Lead Teacher Phone Number * School Phone Number * School * School Mailing Address * School Mailing Address School Mailing Address School Mailing Address City City State/Province State/Province Zip/Postal Zip/Postal Name of School Principal * Name of School Principal First First Last Last Email of School Principal * Approximate start date of school for Fall 2022 * What grade(s)? * 4th 5th OtherOther How many students in Lead Teacher's Class? * How many classes from your school will participate in the VNS program? * 1 2 3 4 5 6 7 Use the drop-down to select the correct number of classes. Second Teacher Name * Second Teacher Name First First Last Last Second Teacher Email * How many students in second teacher's class? (approximate) * Third Teacher Name * Third Teacher Name First First Last Last Third Teacher Email * How many students in third teacher's class? (approximate) * Fourth Teacher's Name * Fourth Teacher's Name First First Last Last Fourth Teacher's Email * How many students in fourth teacher's class? (approximate) * Fifth Teacher's Name * Fifth Teacher's Name First First Last Last Fifth Teacher's Email * How many students in fifth teacher's class? (approximate) * Sixth Teacher's Name * Sixth Teacher's Name First First Last Last Sixth Teacher's Email * How many students in sixth teacher's class? (approximate) * Seventh Teacher's Name * Seventh Teacher's Name First First Last Last Seventh Teacher's Email * How many students in seventh teacher's class? (approximate) * Who was/were your Teaching Naturalist(s) last year (or in a previous year)? * Bailey Zook Alyssa Giffin Alyssa Cornell Drew Lefebvre Ser Anderson Jenah Mead Keri Geiser Stephanie Parker OtherOther As classroom teachers, we agree to actively participate along with our students during each of our monthly naturalist visits in support of the instructional value of the VNS program. * Yes! We agree! The Visiting Naturalist in the Schools Program has the most impact when classroom teachers participate actively in classes. This can include learning alongside your students, sharing your own knowledge and observations, participating in small group work, evaluating your students' VNS journals, and more. If you are unsure of how best to participate, or would like to learn more to help do so, feel free to contact us, or talk with your classroom naturalist! * We understand and acknowledge that we must sign and return the VNS Program Contract (which I will receive by email), in order to complete our registration. Do you agree to pay the VNS program fee of $250 per classroom? * Yes, we agree to pay the per-classroom fee by October 1st, 2022. (If we need to make alternate payment arrangements we will inform the School Programs Manager.) I would like to apply for a VNS program scholarship. In applying for a scholarship I understand and agree to the following: * Scholarships awarded to teachers/schools are always partial, and never offered in full. Filling out this scholarship request form does not guarantee a scholarship. We must provide our own transportation for our school field trips. MNHC does not provide scholarships for transportation. The amount awarded is dependent on the amount of funding MNHC has available to schools in the current school year. The Montana Natural History Center is a private, non-profit organization with a mission to promote and cultivate the appreciation, understanding, and stewardship of nature through education. We believe that natural history education and experiences should be available to everyone and we are committed to making our programs accessible to as many families, schools and individuals as possible. The Montana Natural History Center provides limited scholarship funds for schools that exhibit financial need to attend programs. Requests are based on availability and need on a first-come, first-serve basis. Please describe why you need a scholarship for the VNS program (MNHC cannot provide scholarships for transportation, but we do take this cost into account as part of our scholarship need assessment): * Are you a Title 1 School? * Yes No What percentage of your school is eligible for free or reduced price lunch? * Do you have a PTA/PTO or other parent support organization that can help cover costs? * Yes No OtherOther Have you received a VNS scholarship in the past? * Yes No When did you receive a VNS scholarship in the past? If you know, how much have you generally received previously? * Is there anything else that we should know that would help assess your school’s need for financial assistance? I agree to the following: * As a representative for my school, I attest that the information I have provided is true to the best of my knowledge. MNHC does not grant full scholarships for program costs. We cannot guarantee you will receive a scholarship or that the amount will stay the same from year to year. I acknowledge and understand the previous statements and agree to pay the program cost minus any scholarship awarded to my school. Name of School Secretary (or person we should send program invoices to) * Name of School Secretary (or person we should send program invoices to) First First Last Last Email Address for School Secretary (or person we should send invoices to) * Phone Number of School Secretary (or person we should send invoices to) * Mailing Address for Invoice (if different from school address) Mailing Address for Invoice (if different from school address) Mailing Address for Invoice (if different from school address) Mailing Address for Invoice (if different from school address) City City State/Province State/Province Zip/Postal Zip/Postal Did someone refer you to our program? If so, please provide their name and school, if applicable. 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