Head Start Discovery Field Trip Registration Form School InformationSchool Name County Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Coordinator InformationContact Person Email Phone NumberAlternate Phone NumberProgram DetailsDate (1st Preference) MM slash DD slash YYYY Date (2nd Preference) MM slash DD slash YYYY Date (3rd Preference) MM slash DD slash YYYY Number of StudentsNumber of AdultsNumber of Classes/GroupsPlease note any special accommodations: