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Hazen's   Notch   Association
Bringing People Together to Conserve Vermont's Natural Resources
  ______  Education Program Registration Form  _____

To schedule an education program, complete this registration form and mail it to the HNA at P.O. Box 478, Montgomery Center VT 05471 or email the information to info@hazensnotch.org.

We will confirm your program and the date(s) that you have chosen. Your confirmation package will include a summary of the program, a locator map and travel directions.

Please use a separate Registration Form for each program.




Program Title _______________  Date/Rain Date _______________________

Teacher's Name(s) ________________________________________________

Grade ______    Number of students ______   Number of Chaperones ______

Name of School _______________________   Principal __________________

Address _____________________________

Address _____________________________

Town ________________________________   State ____   Zip Code ______



School Phone _____________________    Email ________________________

School Fax _______________________

Teacher's Home Phone ___________________   Email ___________________

Time Plan to Arrive _______   Time Need to Depart _______

Travel by Bus / Cars ? (Circle)

Special Needs Students: ___________________________________________

________________________________________________________________


Comments _______________________________________________________

_________________________________________________________________




Program Fee: The program fee is based upon the number of students and the duration of your visit. Program fees range from $4 to $8 per student. We will quote the cost of the program when we reply to your fax or email.


Payment: You may pay with a school check, personal check or cash on the day of the program. If your school requires an invoice, please let us know in advance so that we may have it ready for you on the day of your program.


Rain Dates: Please call to confirm your program the day before you arrive. If there is any doubt about the weather for your group's scheduled day, we will - if needed - confer with you early in the morning of the day of your program.

Thank you !

Hazenís Notch Association, Post Office Box 478, Montgomery Center VT 05471
T: (802) 326-4799  ~  F: (802) 326-4966  
E: info@hazensnotch.org  ~   W: www.hazensnotch.org


Copyright 2001-2017 Hazen's Notch Association for the Environment, Inc.
All Rights Reserved.
This page was last updated January 31, 2017.