Group Pass Request

VLM Community Education Program

Group Pass Request

Please review the program guidelines before completing this form. Allow four weeks for processing. If approved, an acceptance letter will be sent to the provided email address.

*All fields are required unless indicated otherwise.

Group Pass Request

Organization Name*
Contact Name*
First Last
Contact Title
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
What is your non-profit organization's EIN (Tax ID)?*
Contact Phone*
Alternate Contact Phone*
Contact Email*
Organization Website (if applicable)
Brief Description of Organization*
Organization Mission*
Sources of Funding: Briefly describe your organization's funding source(s).*
Briefly describe the nature of the visit and what purpose it would serve for your organization and constituents.*
Requested date of visit (if known) Please note that we will consider your requested date, but cannot guarantee availability. Alternate dates and timeframes (morning, afternoon, etc.) may be noted in the Comments section.
Preferred Date for Visit
MM slash DD slash YYYY
Number of passes requested for your group visit (excluding chaperones)*
Please enter a number from 1 to 20.
Number of Chaperones*
Please enter a number from 1 to 2.
Type of group*
I understand acceptance into this program requires my group to submit a thank you letter to the VLM Community Education Program. I agree to submit a letter one week after our VLM experience.*
- Agree
Comments