Schedule a Program

3. 

5. Please fill in all of the information requested below. Incomplete forms may result in a delay in scheduling. Once your form is submitted, you should be redirected to a confirmation page. This confirmation does not mean that your program is scheduled. You should receive an email from one of our staff members within 3 business days to confirm the scheduling of your program. If you do not receive a scheduling confirmation within 3 business days feel free to contact our education team by either emailing Amy Cesak or calling 704-216-7834.

7. Contact Name:*
9. Organization Name:*
10. Organization Type:
    -- Select One --SchoolHomeschoolClubScoutsOther
12. Contact Email: *
13. Contact Phone Number:*
14. County of Residence:*
18. Program Location:*

    1. Virtual (Zoom)

    1. Rowan Wild (on-site)

    1. Outreach to your location
20. Desired Program (Virtual):
    -- Select One --Animal ProgramPoisonous Plants & Venomous AnimalsSkulls and SkinsWorking WildHow do you Zoo?Black BearsRed WolvesWhite-tailed DeerRaptors of North CarolinaSnakes of North CarolinaTurtles of North Carolina
21. List of Virtual Programs
    Virtual Programs
23. Desired Program (On-site):
    -- Select One --Animal ProgramTrail Walk (Persimmon Branch @ Dan Nicholas)Trail Walk (Dunn's Mountain)Trail Walk (Eagle Point)Nature WalkOwl Pellet DissectionPoisonous Plants & Venomous AnimalsNature JournalingSkulls & SkinsWorking WildHow do you Zoo?Box Turtle Connection ProjectOutdoor SkillsHook, Line, and SinkerMacro-invertebrate DetectivesWalter Quality AssessmentBlack BearsRed Wold RecoveryWhite-tailed DeerRaptors of North CarolinaSnakes of North CarolinaTurtles of North Carolina
24. List of On-site Programs
    On-site Programs
26. Desired Program (Outreach):
    -- Select One --Animal ProgramOwl Pellet DissectionPoisonous Plants & Venomous AnimalsWorking WildHow do you Zoo?Skulls & Skins
27. List of Outreach Programs
    Outreach Programs
29. Are you able to use zoom software to engage in virtual programming?

    1. yes
    2. no
31. Address

    Location where the program is to be presented.

33. City
34. State
35. Zip Code
37. Number of Participants:*
    **Please refer to the program list above for individual program minimums**
38. Participant Grade Levels:*

    1. Preschool
    2. Kindergarten
    3. 1st Grade
    4. 2nd Grade
    5. 3rd Grade
    6. 4th Grade
    7. 5th Grade
    8. Middle School
    9. High School
    10. Adult
40. Please indicate your preferred date and time below, as well as two alternate dates and times.

42. Program times must be between 10 a.m. and 2 p.m. 

    All program offerings dependent upon availability. Programs onsite at Dan Nicholas Park are available March through October only. Outreach to your location programs are available year round. 

44. Preferred Program Date & Time:*
    Preferred Program Date & Time:

    Preferred Program Date & Time:
45. Alternate Date & Time 1:*
    Alternate Date & Time 1:

    Alternate Date & Time 1:
46. Alternate Date & Time 2:*
    Alternate Date & Time 2:

    Alternate Date & Time 2:
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field