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Field Trip Application
Print the following form, fill in your information, and fax it to: (866) 673-3331
We will then contact you to confirm your field trip.
Organization/Group name:
Contact Person:
Contact Person Phone #:
Contact Person E-mail:
Contact Person Address:
Number of children in group(min: 5/max: 25):
Age of children in group(min: 3 yrs. old/max: 10 yrs.old):
Choose Field Trip Theme and Fee:
_____Fun With Flowers! ($3.00/per child)
_____Grow Your Favorite Veggies! ($3.00/per child)
_____Pick A Pot & Plant It! ($20.00/per child)
_____Pick A Pumpkin! ($3.00/per child)
x ______ children = $__________________ (total cost)
Please make checks payable to: Clover’s Garden Center.
Note: Adult chaperones are required to stay with the group and are always free!
Contact’s Signature:
Note: You may choose any fundraiser date
& any fundraiser location.
Select Day of Field Trip
(check one):
____ Monday
____ Tuesday
____ Wednesday
____ Thursday
Select Date of Field Trip:
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Select Time of Field Trip
(check one):
____ 10:00 a.m. - 11:00 a.m. ____ 10:30 a.m. - 11:30 a.m.
____ 1:00 p.m. - 2:00 p.m. ____ 1:30 p.m. - 2:30 p.m.
____ 4:00 p.m. - 5:00 p.m. ____ 4:30 p.m. - 5:30 p.m.
____ 5:00 p.m. - 6:00 p.m. ____ 5:30 p.m. - 6:30 p.m.
____ 6:00 p.m. - 7:00 p.m. ____ 6:30 p.m. - 7:30 p.m.
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Select Location of Fundraiser (check one):
__Berwyn
__Elmhurst
__Hickory Hills
__Hometown
__Mount Prospect
__Naperville (on Chicago Ave. - at Butera Market)
__Naperville
(on 75th St. - at Garden Fresh Market)
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__Norridge
__Oak Forest
__St. Charles
__Westmont
__Willowbrook
__other (please list)
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Office use only:
date rec’d:
date confirmed:
confirmed by:
confirmed with:
guide assigned:
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