Virtual School Tour Reservations
School
*
Do any of the following apply to your students?
*
Do any of the following apply to your students?
Title I Schoolwide Program
At least 50% of my students receive free or reduced lunch
None of the Above
Teacher/Contact
*
Lead Teacher for Day of Virtual Tour
*
First
Last
School Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Canada
Australia
Netherlands
France
Germany
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Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
Gabon
Gambia
Georgia
Ghana
Greece
Grenada
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
School District
*
Teacher's Email
*
School Phone
*
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###
-
###
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Cell (for day-of contact)
*
-
###
-
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Class Title
*
Number of Students
*
Age Level
*
Age Level
5th Grade
6th Grade
7th-8th Grade
High School
College
Other
Other
Has your school ever visited Holocaust Museum Los Angeles in the past? If so, when?
*
Date & Time
Date Requested
*
/
MM
/
DD
YYYY
Alternative Date
*
/
MM
/
DD
YYYY
Start Time Requested
*
:
HH
MM
AM
PM
AM/PM
Alternative Start Time
*
:
HH
MM
AM
PM
AM/PM
Are you interested in having a Holocaust survivor speak to your students?
*
Yes
No
If you would like a Holocaust survivor to speak to your students, what day is best?
Same day as tour
Different Day as tour
Requested date for Holocaust survivor talk (only if you need a different date from your tour)
/
MM
/
DD
YYYY
Details
Tell Us About Your Class
*
Rate Your Students' Knowledge of the Holocaust
Rate Your Students' Knowledge of the Holocaust
Excellent
Good
Satisfactory
Limited
Describe Your Class's Familiarity With The Holocaust
*
Please list any Holocaust-related media your class has studied (books, movies, music, etc.)
How did you hear about Holocaust Museum LA?
*
How is your school conducting classes this fall? Please check the following that apply to your class:
*
Virtual classes only
In-person classes only
A mix of both virtual and in-person classes
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