Request a Distance Learning FORM | Midland Center For The Arts

School Name *

School Address (Full Mailing Address) *

Title I School:

Yes No

Contact Name *

Contact Phone Number *

Contact Email *

Grade Range of Students: *

Number of students participating: *

Number of classrooms participating: *

Distance Learning Programs

Please indicate which workshop(s) you'd like to book:

History:

Myself and Others Building My Community Michigan on the Move

Science:

Amazing Magnets Evolving Earth Rocket Power

Arts:

Three Simple Colors From Author to Artist Become a Playwright

Classroom Material Kit:

Send me information about a Classroom Material Supply Kit for an additional fee

Please list three preferred dates and times for our virtual visit to your school: *

Please use this note section to include anything our staff needs to know about your group including if you have accessibility needs. *

Request a Distance Learning Workshop