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Virtual Classroom Chat Request Form
Wild Walks reservations must be made at least 5 WEEKS prior to program date. Non-Refundable deposit of $50 is due at the time of reservation. Final head count is due 4 WEEKS before your scheduled program.
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Organization Name:
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Type of Organization:
(school, daycare, scouts, etc.)
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Organization Street Address:
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Organization City:
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Organization State:
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Organization Zip Code:
Organization County:
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Main Contact First Name:
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Main Contact Last Name:
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Main Contact Email:
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Main Contact Phone:
Are you a tax exempt organization?
Yes
No
Not Applicable
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Are you a Title 1 School?
Yes
No
Not Applicable
Program Theme:
Please choose program theme appropriate for grade level.
K-5th: Amazing Adaptations
6th- 8th: Food for Thought
9th-12th: Living Laboratory
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First Preferred Date:
January
February
March
April
May
June
July
August
September
October
November
December
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28
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30
31
2022
2023
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Second Preferred Date:
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
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9
10
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25
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28
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30
31
2022
2023
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Preferred Start Time:
30 minute program
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How many students will be participating?
30 students max. per session
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Do you have a preferred method of virtually hosting this program?
If not, we will host on our Zoom account.
How did you hear about the Wild Walk program?
Please select all that apply.
Zoo Atlanta School Program Guide
Email / eNewsletter
I am a Zoo Atlanta Member
Zoo Atlanta website
Social media
Advertisement
Word of mouth
Search engine
Event / Expo
Repeat customer
Other: