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Boca Raton Museum of Art
501 Plaza Real, Boca Raton, FL 33432
In Mizner Park
T: 561.392.2500 F: 561.391.6410
Email: info@bocamuseum.org

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Hours:
Tues, Wed & Fri
Thurs
Saturday & Sunday
Mondays & holidays


10AM - 5PM
10AM - 8PM
NOON - 5PM
CLOSED

Admission:
Members
Children(12 & under)
Adults
Seniors(65 +)
Students(with ID)

1st SUNDAY of each month


FREE
FREE
$12
$10
FREE

FREE 

   

2014 Field Trip Grant Application

8TH OFFERING OF THE FIELD TRIP GRANT PROGRAM

Red indicates required fields

APPLICANT INFORMATION

First Name
Last Name
Salutation
 Mr.  Ms.  Mrs.  
Job Title
Grade Level
Subjects
Daytime Phone
Evening Phone
Email
How did you find about about the Field Trip Grant Program?
 www.bocamuseum.org  Museum e-blast  Colleague  Other
 

SCHOOL INFORMATION

School Name
School Address
School City
School State
Zip
School Phone
School FAX
Type of School
 Public  Private  Charter
 
Level of School
 Elementary School  Middle School  High School
 

FIELD TRIP INFORMATION

Name of Field Trip Event/Activity    Boca Raton Museum of Art Field Trip
Field Trip Destination                    Boca Raton Museum of Art, 501 Plaza Real, Boca Raton, FL 33432

List Two Preferred Field Trip Dates
Field Trip Curriculum Connection (Select all that apply)
 Fine Arts  Language Arts  Foreign Arts
 Science  Math  Social Studies
 
Other

Approximately how many students, staff and volunteers will be participating?

Students
Students Grade Level
Staff
Volunteers
Describe the field trip you would like to plan for your students. Include how it will be applicable to your curriculum.
How will students benefit directly from the proposed field trip? How will you measure student learning as it directly results from the field trip?

USE OF FUNDS

Enter how the Grant Monies will be utilized in whole dollars only.

ATTENTION PBCSD EDUCATORS -
BRMA has been on the Approved Field Trip Providers List for the past several years.  The School District of Palm Beach County Fine Arts Department may have funds for grades K-12 for bus transportation. Please apply through Fine Arts Office for free busing.

Transportation
Classroom Supplies
Classroom Resources
Substitute Teacher
Total Cost

VERIFICATION AND CERTIFICATION

The following school administrator, principal or superintendent is aware of and approves my application for a Boca Raton Museum of Art Field Trip Grant. If I am selected to receive a grant, this individual will verify my eligibility for the grant and the proposed field trip.

First Name
Last Name
Salutation
 Mr.  Ms.  Mrs.  
Job Title
Daytime Phone
Email

If selected to receive a Boca Raton Museum of Art Field Trip Grant, you will be required to complete and return a short follow-up survey regarding details of your field trip experience to the Boca Raton Museum of Art. This survey will also provide you the opportunity to comment on the overall process.

By typing my name, I certify that the information contained in this application is correct to the best of my knowledge. I understand that any Field Trip Grant received must be used for the field trip purposes described in this application. I authorize release of this information in this application to the Boca Raton Museum of Art. This application becomes the property of the Boca Raton Museum of Art. I agree that all decisions of the Boca Raton Museum of Art are final. If I am selected to be a recipient, I give permission to the Boca Raton Museum of Art to use my name, school name, photograph and information about the field trip for publicity purposes.

 Check the box to acknowledge having read the guidelines and accept the conditions set forth.

By typing my name, I agree to the rules and eligibility for submitting an application to the to the Boca Raton Museum of Art Field Trip Grant program. I understand that this electronic signature has the same legal authority as my handwritten signature.

Applicant's Signature (Full Name)
Date
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What is a CVV Code?

CVV2 is a security measure for credit cards. Since a CVV2 number is listed on your credit card, but is not stored anywhere, the only way to know the correct CVV2 number for your credit card is to physically have possession of the card itself. All VISA, Discover, MasterCard and American Express cards made in America in the past 5 years or so have a CVV2 number. However Diners Club does not use a security code.

How to find your CVV2 number:
On a VISA, Discover or MasterCard, please turn your card over and look in the signature strip. You will find (either the entire 16-digit string of your card number, OR just the last 4 digits), followed by a space, followed by a 3-digit number. That 3-digit number is your CVV2 number.(See below)

VISA, Discover & MasterCard


On American Express Cards, the CVV2 number is a 4-digit number that appears above the end of your card number. (See below)