Today's Date: 11/20/08

1st - 2nd - 3rd Choice of dates for Visit:

1)
2)
3)

Name of Group Non-School or School:

Arrival Time:

Departure Time:

There are no lunch facilities. If nice weather, picnic tables are available outside. If inclement weather,
plan on having lunch on buses.
Lunch: Yes No   If yes, time:

Is the group visiting the Planetarium also?
(Contact Mark Mazurkiewicz Phone 610 371-5850 x244 to schedule a Planetarium Show)
Yes No   If yes, time:

Title of Contact Person filling out form:

Contact Email:

Contact Phone, Fax:

Address (If School, Include County and District):

Grade Level and type of class:

Name of Team Members:

Type of tour requested, Self guided or Gallery Teacher Led:
Self Guided Gallery Teacher

Self guided tours must have prepared material. Please let us know if we can help you.
Yes No

Subjects being studied and Focus of Tour:
(See pages listing tour titles and Temporary exhibits on our website – readingpublicmuseum.org)

1st – 2nd – 3rd Choices of galleries to be viewed:

1)
2)
3)

Admission: Group Rates

Number of paying students:
($3.00 per student, ages 4-17 years; $4.00 per student with Gallery Teacher)

Number of paying adults (There must be 1 adult for every 10 children):
($5.00) per adult

Number of complimentary (Members, or RSD) students:

Number of complimentary (Members, or RSD) adults:

Amount Due:


Is the group planning to visit the Museum Shop?
(Please note: Only 10 students at a time will be allowed in the Shop, adults must oversee shopping)
Yes No   If yes, time: