Field Trip or Tour Reservation Request Form Field Trip or Tour Reservation Request2 Review Our Teacher Checklist for More Information Your Name * First Last * Last Email Primary Phone * Alternate Phone 1. CLICK ON ANY PROGRAM SECTION BELOW2. SELECT A PROGRAM TO RESERVE & FILL OUT PROGRAM SECTION 3. FILL OUT THE GROUP INFO SECTION, INCLUDING YOUR DATE(S) SELECTION4. SUBMIT THE FORM FIELD TRIPS - STUDENTS School Field Trip - Education Program * Become a Spy at the Brewster House Medicine's Past, Present & Future at the Thompson House The "Dusty" Program at the Stony Brook Grist Mill A Day in the Life of a Native American Family at the Ernst Marine Conservation Center School School District School Address School Address School Address School Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal VIRTUAL FIELD TRIPS / DISTANCE LEARNING Virtual Programs Running Scared, Running Free: Escape to the Promiseland Window Through Time: Journals of American Revolution War Spies at the Brewster House First Long Islanders: Original Inhabitants The Coastal Ecology Program School School District School Address School Address School Address School Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal SEASONAL STUDENT PROGRAMS Spring Break Programs Program #1 Program #2 Summer Break Programs Program # 1 Program # 2 Winter Break Programs Program #1 Program #2 School School District School Address School Address School Address School Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal ADULT PROGRAMS Adult Programs The Stony Brook Grist Mill The Brewster House The Thompson House The Ernst Marine Conservation Center Program Group Mailing Address Group Mailing Address Group Mailing Address Group Mailing Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country GROUP INFO Organization / Group Name Total Participants in My Group * Introduce your group to us, including any special needs, interests, and/or what makes your class unique. What goals would you like to achieve with this program? DATE PREFERENCES #1 Preferred Date * #1 Preferred Time * (Type Time Range) #2 Preferred Date #2 Preferred Time (Type Time Range) #3 Preferred Date #3 Preferred Time (Type Time Range) GROUP CONTACT INFO: Contact #1 Name * Contact #1 Phone Contact #1 Email Address * Contact #2 Name Contact #2 Phone *** Payment must be arranged with your school or district prior to your visit. *** *** We accept checks, credit cards, or purchase orders. *** ***PURCHASE ORDERS MAY BE SUBMITTED BY FAX TO: 631-751-2024 *** Contact #2 Email Address Captcha