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Program Information Request Form

To learn more about scheduling a program for your school or group, please complete this request form and a member of our staff will contact you shortly. To speak with someone today, you may email or give us a call at (800) 706-0432, x225.

Contact Information

Your Name:
Organization/School:
Address:
City:	State: Zip/Postal Code:
Country:
Phone:	Ext.
Email:

Who will be attending?

How many participants will be in your group?

Age range / Grade:

What type of program are you interested in?

Distance Learning

Extreme Weather Observations
Fundamentals of Climate
Life and Work at the Mount Washington Observatory
The Alpine Zone
Custom Program

Classroom programs

Observing Mount Washington's Weather
Lightning Science and Safety
Fundamentals of Climate
Custom Program

Lecture for the general public
Teacher training
Camp-in at the Weather Discovery Center

Where would you like to conduct the program?

My organization or school
Mount Washington Observatory Weather Discovery Center
Mount Washington Observatory summit weather station (teacher trainings only)

Please indicate the date and time that you are interested in scheduling a program:

Program Start Time:

Alternate date and time in case your first choice is not available:

Program Start Time:

Would you like to receive periodic news and information updates from Mount Washington Observatory?

Yes No

How did you hear about our educational programs?

Verification:

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Administration: 2779 White Mountain Highway, P. O. Box 2310, North Conway, NH 03860 • Tel: 603-356-2137 • Fax: 603-356-0307 • contact us

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