2012-13 Student Matinee Application

It is the responsibility of the school representative and principal to determine whether a play is appropriate for their particular group. Alley Theatre does not censor or edit the content of a play for the Student Matinee program.

Before processing request for student matinee performances, please consider how the Student Matinee program will be utilized by your school and teachers to support student learning.

Take into account all of the following components

Classroom Preparations
Travel Arrangements
Attending a play at the Alley Theatre
Teacher Preparation Workshop
Teacher Guide
In School Pre-and/or Post Performance Workshop

When reviewing applications for the Student Matinee program, we reserve the right to give priority to teachers and schools who have a higher commitment to theatre and cultural learning.

*Required field(s) are indicated by an .**
* I have read How to Order Student Matinee Tickets, and I understand and agree to the terms.	For process and terms, read How to Order Student Matinee Tickets.
Select your preferred productions and performance dates Death of a Salesman Please note: All student matinees start at 10 a.m. Cost is $12.50/ticket
Preferred Date
Alternative Date
Estimated Group Size	(Total number of students, teachers, and chaperones)
What are your travel arrangements?
How many adults (parents, teachers, and chaperones) are attending the Student Matinee with you?
A Christmas Carol Please note: All student matinees start at 10 a.m. Cost is $12.50/ticket
Preferred Date
Alternative Date
Second Alternative Date
Estimated Group Size	(Total number of students, teachers, and chaperones)
What are your travel arrangments?
How many adults (parents, teachers, and chaperones) are attending the Student Matinee with you?
Contact Information
* Your Name

Please indicate if you are a...	Teacher at a school Home school teacher Youth group leader PTO/PTA delegate
If not any of these, please describe your situation.

* School or Group Name
Are you the school or organization representative who will coordinate the field trip and attend with the students? * Yes No
If you are not serving as the representative, provide the name and the contact information for another who will do so.
* School or Organization Representative
* Your School or Organizaton Representatives Title of Position
* School or Group Address
* City	* State * Zip
Website
Fax Number
* School Phone Number
* Cell Phone Number
* Email Address
* Alternative Email Address
* Is this a public, private, or home school?
If this is a public school, please name the school district:
What grade levels?	(Are they all 5th grade students? Is it a mix of 9 - 12th grade?)
What type of class is participating? * (A Special Education class, students in Gifted & Talented program or part of a club?)
Have you previously attended a Student Matinee performance? *
What was the last Alley Theatre production you attended with your students?
Does your school or organization participate in other educational programs at the Alley Theatre or with other theaters, performance groups or cultural organizations? If so, please tell us how long you have been involved and describe how the collaborations benefit your students?

Without enthusiastic and stongly committed teachers, the Alley Theatre Student Matinee Program cannot succeed. Please tell us how your group or team plans to intergrate Alley Theatre plays, guides and professional development into your class or youth work.

Have you received permission from your school principal? *
* School principal's name
* School principal's e-mail
Do you have any exam dates that will conflict with the Student Matinee performance?
Please select a Pre- & Post-Performance Workshop * What is a Pre- & Post-Performance Workshop?
Do any group members require special services? Check the boxes for the services that apply.
Hearing Impaired	The Alley Theatre does not provide interpreters for the student matinee performances. If you have hearing impaired students that require an interpreter, please note that this is a service your school/organization must provide. Upon your request, the Alley Theater can provide you with a script for your interpreter.
Hearing Devices
Wheelchair Seating
Other Special Services
Comments
Comments and Special Requests

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