Teacher Workshops Application, Fall/Winter 1997-98 Name________________________________ Grade Level_____________ School___________________________ Region#/District #_________ School Address_______________________________________________ City/State/Zip_______________________________________________ Home Address_________________________________________________ City/State/Zip_______________________________________________ Day Phone / Evening Phone____________________________________ Check the Appropriate Line: ____Chicago Public School ____Parochial School ____Suburban School ____Private School Program Name_________________________ Date(s)________ Fee____ Program Name_________________________ Date(s)________ Fee____ Program Name_________________________ Date(s)________ Fee____ Duplicate form to list more workshop titles. Only one teacher per form. Make copies of form for other teachers. ______Send me information about zoo membership. Zoo Tour/Exhibit Activity Application Fall/Winter 1997-98 (Available November-February) Name of School_____________________ Region#/District #________ School Address________________________________________________ City/State/Zip________________________________________________ Contact Name__________________________________________________ Names and grades of attending teachers: ____________________________________________Grade ____________ ____________________________________________Grade ____________ ____________________________________________Grade ____________ School Phone _________________________________________________ Contact's Home Phone__________________________________________ Total # of Students ____________________ Total # of Adults ______________________ Total # of Buses _______________________ Zoo Tour/Exhibit Activity Name ________________________________ List Three Alternate Dates: 1st________________2nd______________________3rd________________ _____Send me information about zoo membership. To apply for any teacher workshop, tour, or exhibit activity, print this page, complete the appropriate application form and mail to: Lincoln Park Zoo Education Department P.O. Box 14903 Chicago, IL 60614 or FAX to 312/742-2040 Teachers will receive confirmation letters.