Heard on the Go Sign-up Full Name:(Required) First Last Email:(Required) Educational Institution:Phone:(Required)School Name:(Required)School Address:(Required)School District:(Required)School Website:(Required)Title 1?(Required) Yes No Grade Levels of Students Reached: Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Number of Students Reached:(Required)Preferred Check-out Start Date:(Required) MM slash DD slash YYYY Note that “Heard on the Go” is available for a 2-week loan. Ex: Month/Day/Year 01/01/2023Alternate Check-out Start Date #2:(Required) MM slash DD slash YYYY Note that “Heard on the Go” is available for a 2-week loan. Ex: Month/Day/Year 01/01/2023Alternate Check-out Start Date #3:(Required) MM slash DD slash YYYY Note that “Heard on the Go” is available for a 2-week loan. Ex: Month/Day/Year 01/01/2023Please review the following: (Required) By checking this box, I have read and understand all requirements prior to submitting this form.Heard on the Go cases are rented for a maximum of 2 weeks. Transporting the cases is the responsibility of the partner organization. Please ensure that the Heard on the Go resource is being used strictly for educational purposes. One-time use materials, such as air-dry clay, sticks, plates, etc., are not required to be returned in the case. All other materials must be returned in the cases in their corresponding places. Teachers are required to fill out a survey prior to returning the cases to the Heard Museum. Any damage or missing pieces should be noted in this survey.
