Cleveland Metroparks Zoo

Distance Learning
By Request Form

Exciting Opportunities for Everyone...
Teachers	Families	Volunteers
Students	Groups	AIP Master's

Distance Learning By Request Form

* Information Required

* Zoo Program Title:	Octopus: Undersea Alien Polly Wants a Future (Parrot Preservation) Career - Marketing and Public Relations
* Program Date:
* Program Time Request: (It helps in scheduling to have more than one time option for a by-request program, the first one is required)	* Time request 1: Time request 2: Time request 3:
* Number of students:
Grade Level:
* School name:
* Classroom Teacher:
* Teacher E-mail:
* Street Address:
* City: * State: * Zip:
* Teacher/School Phone:

Technical Contact Information: (Note: All confirmations are emailed to the teacher and technical contact.)
* Contact Name:
* Phone:
* Email:

Distance Learning Specifications: (Note: If the participating site is registered with the State of Ohio State (eTech), the exact name of the site MUST be listed. An incorrect entry may result in a denied application.)
DL Site Name:
* IP #:
* Phone Number at Site:
Additional comments:

* I understand that this is a program request only. Cleveland Metroparks Zoo does not guarantee a program based on this request. By request programs are subjected to the presenter's availability and limited to 2-3 a semester.

PLEASE NOTE:

Availability is on a first-come first-served basis. Please reply via email.
Confirmation will be returned via email within one week of program date.
Lesson plans can be downloaded directly from the Zoo's web site.

If you have any questions, please email Cathy Ryan-Smith at or call 216_661_6500 x.4479.

Distance Learning home.