RID Program Request Form

Your Name *

Email Address *

Phone Number XXX-XXX-XXXX *

Name of School *

Address *

City, State, Zip *

How many students will we be working with? *

Grade *

7th

8th

1st EDUCATOR PROGRAM classroom visit - Please list 3 preferred dates as well as the times your class(es) meet, then select preferred program below. *

*

Context of the Holocaust

History of the Holocaust

2nd EDUCATOR PROGRAM classroom visit - Please list 3 preferred dates as well as the times your class(es) meet, then select preferred program below. *

*

Context of the Holocaust

History of the Holocaust

Standing Up instead of Standing By

Genocide Today

3rd EDUCATOR PROGRAM classroom visit - Please list 3 preferred dates as well as the times your class(es) meet, then select preferred program below.

Standing Up instead of Standing By

Genocide Today

4th EDUCATOR PROGRAM classroom visit - Please list 3 preferred dates as well as the times your class(es) meet, then select preferred program below.

Standing Up instead of Standing By

Genocide Today

Other (indicate in field below):

FIELD TRIP - Please list 3 preferred dates & select preferred field trip below.

From Ignorance & Fear to Knowledge & Understanding: Jews, Judaism, & the Holocaust (FIF)

Jewish Museum Milwaukee visit

Illinois Holocaust Museum & Education Center visit

Pinat Hativah: A Corner of Hope

HOLOCAUST MATERIALS TRUNK - Please list preferred 3 week range for rental & select preferred trunk below.

Middle School Trunk

High Shool Trunk

SPEAKERS BUREAU classroom visit - Please list 3 preferred dates/times.

Additional Questions or Comments: