Museum of Tolerance

After this request form is completed and returned we will contact you to confirm your Virtual Field Trip.

Contact Information

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Name:

First Name Required	Last Name Required

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Email: Required

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Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

*

Phone Number: Required

If you respond and have not already registered, you will receive periodic updates and communications from Simon Wiesenthal Center.

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Question - Required - Position/Title:

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Question - Required - School / Organization:

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Question - Required - Preferred Date 1:

Month

Day

Year

Question - Not Required - Preferred Date 2:

Month

Day

Year

Question - Not Required - Preferred Date 3:

Month

Day

Year

*

Question - Required - Total number of students who we would like to schedule for.:

*

Question - Required - Select the modules you are interested in booking:
Please make at least 1 selection from the choices below.

	Anne Frank Exhibit
	Social Lab Exhibit
	Holocaust Exhibit
	Combat Hate
	Holocaust Survivor Personal Testimony

The fee for the Virtual Field Trips is $250.00 per module for a class of 25-30. The Combat Hate program is $300.00 per module for a class of 25-30.
Payment can be made by check, Visa, Mastercard, and American Express.

Limited grant funds are available, please contact us for details

This form is only to request a Virtual Field Trip and is not a confirmation of your program.

We will send you confirmation materials upon review of your application. If you do not hear from us please contact groupsales@museumoftolerance.com to confirm that your application was submitted.

For additional information and questions please e-mail groupsales@museumoftolerance.com.

Virtual Field Trips for Students