Gary E. Sampson Planetarium Scheduling Request Form

Please enter the appropriate information below.:

Please note - the answers to any question preceeded by a "*" are mandatory. You will not be able to submit this request unless those questions are answered.
1.
*

School District Name
2.
*

School Name
3.
*

Teacher Name
4.
*

Teacher Phone Number
5.
*

School Fax Number (where to send the invoice)
6.
*

Grade Level
7.
*

Number of Students
8.
*

Number of Teachers and Chaperones

Note: - total number of attendees (students + teachers + chaperones) should not exceed 60
9.
*

Choose the show that you would like to schedule from the following drop down list. 

A full description of each show can be viewed at:

http://www.wauwatosa.k12.wi.us/schools/high/west/we_dezeeuto_showlist.cfm
10.
*

Choose your preferred show time.
09:30 am   1:00 pm
Evening
11.
*

Enter your preferred date for showing.
12.

Please write any questions or comments that you may have here.

PLEASE NOTE THAT SUBMISSION OF THIS FORM IS ONLY A REQUEST.  YOUR SHOW WILL NOT BE CONSIDERED SCHEDULED UNTIL YOU HAVE RECEIVED A CONFIRMATION EMAIL FROM THE PLANETARIUM DIRECTOR.

* Enter Your Email Address:

Type in the text that you see above:

  

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The Wauwatosa School District does not discriminate on the basis of a person's color, sex, race, religion, national origin, ancestry, creed, pregnancy, marital status, sexual orientation, or physical, mental, emotional or learning disability.
Wauwatosa School District · 12121 West North Avenue · Wauwatosa, WI 53226 · 414-773-1000