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Jackie Robinson Timeline and Learning Guide Request
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Complete the following form to request a set of Jackie Robinson Museum Timeline and Learning Guides for your class.
Classroom sets are pre-counted sets of 30 and supplies are limited.
Learning Guide booklets will be shipped to your school at no charge (for schools in the United States). Depending on location, international shipping may not be available.
If you have also booked a field trip you
do not
need to complete this form. A set of booklets will be mailed as part of your field trip reservation.
Device Type Organization Email (Hidden)
Assistant Email
Assistant Mobile
Assistant Org Phone
Default Email
Home Fax
Mobile Phone
Organization Email
Organization Fax
Organization Phone
Personal Email
Personal Phone
Email Address
Email formula to copy the device value (Hidden)
First Name
Last Name
Title
School or Organization Name
School CEEB Hidden
School or Organization Mailing Address
School or Organization Mailing Address
Country
Street
City
Region
Postal Code
Organization Category
Elementary School
Middle School
High School
Community Organization
Organization Type
Charter
Special Education Program
Home School
Independent
Public
Religious
How many classroom sets (30 booklets) would you like?
How many classroom sets (30 booklets) would you like?
1
2
3
4
5
Grade Level(s) of Students
What grades will the resource guides be distributed to?
Grade Level(s) of Students
What grades will the resource guides be distributed to?
K
1
2
3
4
5
6
7
8
9
10
11
12
The booklet is also available in Spanish. Do you require any copies in Spanish?
The booklet is also available in Spanish. Do you require any copies in Spanish?
Yes
No
How many copies of the booklet do you need in Spanish?
Submit