2021-22 Act One Arts Immersion VR Field Trip Interest Form Interested in being first on the list for an Arts Immersion experience? Fill out the form below and we will contact you to discuss details. Contact Information First Name Last Name Your Email Phone School Information Name of School Name of School District or Charter Holder (put NA if no district/charter holder) School Main Office Phone School Website Address (format address with “www” first) Address Line 1 City State Please select…Arizona Postal Code Is your school a Schoolwide Title 1 school? YesNoI don’t know (You can find your school’s Title 1 status at https://geo.azmag.gov/schoolsdatacenter/.) Group Information In an effort to more effectively and efficiently manage the Arts Immersion Virtual Reality program and to better communicate with you regarding your field trip, we are asking that each request for a group be made individually. We can accommodate up to 50 students per hour-long field trip, depending on the space you’d like us to utilize at your school. What grade(s) are the students attending the field trip? (Please include all grades coming in this group.) 5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th Grade How many STUDENTS will participate in Arts Immersion Virtual Reality? (Please estimate the actual number of students you anticipate will attend.) How many TEACHERS/EDUCATORS will be present? Contact Information