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Fifth Grade Reservation Form
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Fifth Grade Reservation Form
Museum of History and Holocaust Education
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Organization Name
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Organization Phone
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Contact Name
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Contact Phone
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Contact Email
First Choice for Tour Date
Second Choice for Tour Date
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Preferred Arrival Time
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Grade Level
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Number of Students
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Number of Chaperones
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Is this your first field trip to the museum?
Yes
No
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Describe the time your students will spend on the study of the Holocaust and World War II prior to your visit
less than one week
one to two weeks
two or more weeks
none
Please tell us if you have a number of students who are
English Second Language (ESOL/ELL)
Proficient/Distinguished Learners
Beginning/Developing Learners
Hearing and/or Visual Impairment
What are your learning objectives for this visit?
Choose one tour option from each section.
*
Choose one
Parallel Journeys General Tour (A 30-minute exhibition talk given by a museum guide)
Parallel Paths Activity (A 30-minute museum activity exploring the stories and choices of teenagers and young adults during the Holocaust.)
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Choose one
Short Life of Anne Frank Film
Women in Wartime Film
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Choose one
Georgia Goes to War Exhibit Investigation (Explore war contributions from different geographic regions throughout the state of Georgia)
The Sky's the Limit: Women Pilots of World War II Exhibit Exploration (Engage with artifacts, maps and other exhibit elements)
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Optional 30 minute extension (pick one)
Point Rationing System Activity
Draw What You See - Art in the Holocaust Activity
Wartime Production STEM Activity
Paratrooper Plummet STEM Activity
Please select which of our other free resources you have reserved/used for this school-year (Check All That Apply):
In-School Programs
Traveling Exhibitions
Traveling Trunks
Legacy Series Oral History Program
Online Teacher Guides
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