Today's Date:
Please select three possible date for your visit in order of reference.  You will receive an e-mail confirming your reservation for the first available date.
Date 1:	Date: 2	Date:3
What time will you arrive? (Please be aware you should plan a 1 1/2 to 2 hour visit).

If you are arriving around lunchtime and would like to eat lunch at Westminster, please select one of the following options:  (See our Lunch Options for more information).
	Box lunches: $8.95 Includes a sandwich, chips, cookie, and drink.
	Dining Hall: $5.00 Served from 11am-1pm, come experience college life in Westminster’s dining hall.
	Sack lunches: Free Bring your own lunches and eat outside in the courtyard or by “Breakthrough”, a sculpture created from the Berlin Wall.

Number of Students expected:	Student Grade Level(s):
Number of Chaperones (1 per 10 - 15 students required)

School/Group Name:
Contact Name:
Contact Phone:
Contact E-mail:
Contact Title (choose one):	Teacher
	Principal
	Counselor
	Other
School Address (line 1):
School Address (line 2):
City:	State:	Zip:
School Phone:
Would you like a complimentary copy of our curriculum CD entitled Exploring Churchill and His Century (all information on CD is on our website as well)?
Yes   No
Special Instructions (space provided below for any additional information you feel is necessary):
How did you hear about us?