BRONX ZOO Distance Learning
Expeditions Registration Request Form

Thank you for your interest in the Bronx Zoo Distance Learning Expeditions. Registration forms must be received at least 3 weeks prior to the requested date and are booked on a first come, first served basis. Filling out a registration form does not guarantee a requested date/time. The education staff will do it’s best to accommodate your schedule. Please email distancelearning@wcs.org or call 718-741-1693 with any questions.

* Denotes a required field

Select a Video Conference & the number of programs *
 
Animal Colors, K-3

 
 
Time
Time
Time
Time
Time

 
Person Requesting Program

 
 

  Phone: *
Email: *
   Fax:
 



Teacher, School, & Student Information

 
 

 

 

   
 
   
 
   

 


(Maximum response 255 chars.)

 
Technical Information

 
 
 
 
 
 
 

Connection type: *
  ISDN connection speed (KBPS):
 
   
Time zone: *   Daylight Savings practiced?


 
Billing Information

 
 

   
 
   
 
   
 

(A copy must be faxed or mailed to BRONX Zoo by the date indicated on your invoice.)

 
   Please leave this field empty