Transportation Grant

Select County *
Los Angeles San Diego Orange San Bernardino Riverside Ventura
Eligibility Checklist (All schools except San Diego schools must meet at least one of the following requirements to be considered. San Diego schools can leave blank.)
Title 1 Designated - Schoolwide 50% of your students qualify for free or reduced lunch through the National School Lunch Program
School District *
Name of School *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School Phone Number * - ### - ### ####
Teacher Phone Number - ### - ### ####
Email *
Teacher/Chaperone Name (for day of visit) *
Teacher/Chaperone Cell (for day of visit) * - ### - ### ####
Principal Name
Subject/Course Title
Number of Students (We can accommodate up to 68 students in one trip.) *
Age Level *

Age Level 5th Grade 6th Grade 7th-8th Grade High School Other (explain)
Date & Time
Field Trip Date Requested * / MM / DD YYYY
Alternative Field Trip Date Requested * / MM / DD YYYY
Tour Time Requested (San Diego schools must choose an arrival time between 11:00am and 2:00pm) *

Tour Time Requested (San Diego schools must choose an arrival time between 11:00am and 2:00pm) 10:00 AM - 1:00 PM 11:00 AM - 2:00 PM 12:00 AM-3:00 PM 1:00 PM - 4:00 PM 2:00 PM- 5:00 PM
Number of buses needed:

Number of buses needed: 1 2 3
Estimated Total Cost: $ . Dollars Cents
Details
Have you ever received a transportation grant from Holocaust Museum LA? *
Yes No
Tell Us About Your Class *
Has your class ever visited Los Angeles Museum of the Holocaust before? If so, when?
Describe your students' familiarity with the Holocaust *
How did you hear about Los Angeles Museum of the Holocaust?
Teacher's Initials (Your initials indicate your agreement to complete a teacher feedback form after your visit)
Principal's Initials
Support Letter
Please tell us your reasons for applying for a transportation grant. *
Spam Protection. Please answer this simple question.
2, 40, 8, 1 : which of these is the largest?

Transportation Grant

Date & Time

Details

Support Letter