Group Tour or Service-learning Reservation Request

Group/school name: _________________________________________________________________
Mailing address: ___________________________ City: __________  State: _____ Zip : ____________
Contact Person (teacher/group leader): _______________________ Age/grade of youth: __________
Phone: _____________________________  Email: ________________________________________
What is the best way to contact you? Please check one. Phone: ____    Email: ____
Date/time would you like to visit:
1st choice: ________________________  2nd choice: _________________________ 
How many will be in your group? No. of adults (18 & older): ___________  No. of youth : ____________
 Will anyone in your group have special needs that require special attention? (Please explain):
Allergy information: We use peanut products at the farm in animal feed and composting materials. Visitors will also be exposed a wide variety of plants and animals. Please let us know us if anyone in your group is allergic to peanuts, bees, etc.

So that we may prepare for your visit, please answer the questions below:

1. Please number the topics we offer at the Sanctuary in order of preference for your group:
____ People Care activities that involve teamwork, cooperation, collaboration, reflection, respect and dignity
____ Animal Care visiting rescued animals, humane care and treatment of animals, exploring an animal’s perspective
____ Earth Care permaculture, organic gardening, composting, sustainability, environmental literacy
2. Please describe your goal as a teacher or group leader in bringing your group to the Sanctuary:  

3. Is your trip to the Sanctuary part of your groups’ ongoing educational or recreational activities? If yes, how?  

4. How did you hear about us? Flyer ___ TV ___ Newspaper ___ Word of mouth ___ Internet  ___ Other ________

5. Additional comments, concerns, or questions:   
 
Required minimum donation 
More gratefully accepted. We receive no government funding and rely on donations to stay open.

Less than 20 people	$100.00
21 to 50 people		$200.00
51 or more people	$300.00

Checks are preferred, but cash is accepted, and credit card donations may be made to our website, www.SanctuaryOne.org.

Please email the completed form to Della Merrill, General Manager, at education@SanctuaryOne.org

Or post mail to:  

Sanctuary One
13195 Upper Applegate Road
Jacksonville, OR 97530

We are delighted that you have chosen to visit us and will contact you to discuss your group tour or service-learning experience. If we can be of further assistance please feel free to contact Della Merrill, General Manager, at education@SanctuaryOne.org  or 541.899.8627.