Leslie Website Administration Tool

Off-Site Program Reservation

Program

Teacher/Organizer First Name:

Last Name:

School/Organization:

Address:

Phone:

Email:

# of Children/Program (30 max)

How many programs in 1 day:

Grade:

When would you like to participate in our program?

First Choice:

Second Choice:

Third Choice:

Please provide desired start and end times:

Start Time:

End Time:

Leslie Science and Nature Center 1831 Traver Rd. Ann Arbor MI 48105 ■ 734-997-1553 ■ info@lesliesnc.org
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	Off-Site Program Reservation Program Teacher/Organizer First Name: Last Name: School/Organization: Address: Phone: Email: # of Children/Program (30 max) How many programs in 1 day: Grade: When would you like to participate in our program? First Choice: Second Choice: Third Choice: Please provide desired start and end times: Start Time: End Time: