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 Select Date of Field Trip: |
Select Time of Field Trip (check one): ____ 10:00 a.m. - 11:00 a.m. |
Select Location of Fundraiser (check one): __Berwyn __Elmhurst __Hickory Hills __Hometown __Mount Prospect __Naperville __Naperville |
__Norridge __Oak Forest __St. Charles __Westmont __Willowbrook __other |
Office use only:
date rec’d:
date confirmed:
confirmed by:
confirmed with:
guide assigned: