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Kansas Day at the Museum Registration

Use this form to register for Kansas Day at the Kansas Museum of History. Your registration will be complete when you receive a confirmation.

Day of the Week: Friday  

Date:

January 27, 2012  

Start Time:

 

Tour:

Number of students:

 

Grade:

 

Number of adults:

 

Contact Person:

 

Phone Number:

 

School/Organization:

 

USD:

 

Address:

 

City:

 

State:

 

ZIP Code:

 

County, if Kansas:

 

Disabilities/Special Needs

 

Museum Store:

 

Email Address:

 

Additional Comments:

 
   

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