MVCC High School Group Visit Request Form

School/Group Name:

Today's Date:

Contact Person:

Contact Title:

Approximate
Number of
Attendees:

Contact Phone Number:

Contact Cell Phone Number:

Contact E-Mail Address:

Grade of Students :

First Choice of Visit Date:

Second Choice of Visit Date:

Estimated Arrival Time:

Estimated Departure Time:

What would you like to do on your visit?

Other:

Please indicate if any members of your group are in need of accommodations (disability/dietary) while on your visit:

Additional Notes: