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GROUP INFORMATION
This form is to be used by Group Leaders for visits from January 1, 2012 through December 31, 2013. Program Request is due at least six weeks before the Group Main Arrival Date. Programs are subject to availability. A minimum of 10 students is required for program participation unless otherwise noted.
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SCHOOL / ORGANIZATION NAME *
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GROUP NAME *
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SCHOOL / ORGANIZATION MAILING ADDRESS *
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CITY *
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STATE *
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ZIP *
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SCHOOL / ORGANIZATION PHONE *
(with area code)
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SCHOOL / ORGANIZATION FAX *
(with area code)
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GROUP LEADER NAME *
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GROUP LEADER TITLE *
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GROUP LEADER PHONE *
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GROUP LEADER EMAIL ADDRESS *
(Permission granted to follow-up with electronic correspondence)
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ARRIVAL DATE *
(2012 - 2013 Dates Only)
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DEPARTURE DATE *
(2012 - 2013 Dates Only)
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TRAVEL PLANNER INFORMATION (Optional)
Travel Agency
Contact Name
Address (No PO Boxes please)
City
State / Providence
Postal Code
Country
Telephone
(with area code)
Fax
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Email Address
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ALTERNATE PROGRAM REQUEST
ALTERNATE PROGRAM *
-- Select --
-- ARTS AND HUMANITIES --
The American Story
Disney’s Animation Magic
Disney’s Captivating Moments
Disney’s Production Arts and Sciences
Magic Behind the Show
Millennium Cultures
Showbiz Magic at La Nouba™
-- CAREERS AND LIFE MANAGEMENT --
Disney’s Emerging Leadership
Disney’s Leadership Excellence
Keepers of the Kingdom
Making Waves
The Science of Disney Imagineering
-- NATURAL SCIENCES --
Disney’s Ocean Discoveries
Disney’s Wild by Nature
Team Up for Wildlife
-- PHYSICAL SCIENCES --
Dynamics of Technology
Disney’s World of Physics: Energy and Waves
Disney’s World of Physics: Properties of Motion
Everyday Chemistry
How Things Move
Synergy in Science
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DATE *
(2012 - 2013 Dates Only)
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Disney Youth Education Series Program Terms and Conditions: Groups wishing to participate in a Disney Youth Education Series program must complete and submit this Program Request Form via Online or Fax to 407-566-7688. This form should be submitted as soon as program choices are made and at least six weeks in advance . This form may, however, be submitted up to 12 months in advance. Upon the group’s acceptance into any Disney Youth Education Series program experience, the Group Leader will receive written confirmation of the scheduled program(s), date(s) and time(s). To finalize your participation in Youth Education Series program(s), the Group must complete and submit a Ticket Order form prior to the Group Main Arrival Date.
• All programs subject to availability and are three hours in length unless otherwise noted. Program content, times and locations are subject to change due to inclement weather, attraction availability, or group dynamics. A minimum of 10 students is required for program participation unless otherwise noted. Each youth participant must meet stated grade level and age requirements and all posted Disney safety guidelines.
• Theme Park admission is required and all participants must purchase a Disney Youth Education Series Ticket Package to attend any Disney Youth Education Series program.
• Prerequisite: Group must attend La Nouba ™ show prior to Showbiz Magic Youth Education Series Program.
• To maintain the high-quality and age-appropriate Disney Youth Education Series learning experience, no more than one adult for every five participating students may attend Disney Youth Education Series programs. How Things Move requires one chaperone for every student if the student is age 5 or 6 years old.
• One YES program is included in each Disney Youth Education Series Ticket Package. For dates in 2012 , additional programs are available at a cost of $26.00 per participant. For dates in 2013 , additional programs are available at a cost of $27.00 per participant. (**Please note, an additional premium program fee of $12.00 is required for all participants of The Science of Disney Imagineering: The Experience).
• Groups must arrange their own transportation to and from ALL programs and options. Walt Disney World ® Transportation is not available.
I have read and understand the application procedures *
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Signature *
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Your Email Address *
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