Ann Arbor Hands-On Museum Discover Science Assistance Fund Application These scholarships are made possible by the generosity of many friends of the Ann Arbor Hands-On Museum. Please complete this form and click the Submit button below. (Or click here for a printable form to send by mail or fax.) We will contact you by email or phone within 5 business days with the status of your request.

* Name of School
* Date of Visit
* Name of School District
* Title 1 School? Yes/No
* Percentage of Students Receiving Free/Reduced Lunches
* Name of Teacher
* Student Grade Level
* Number of Students
* Number of Teachers/Chaperones
School Address: Street (Line 1)
School Address: Street (Line 2, if needed)
School Address: City
School Address: State
School Address: Zip
* Phone
* Email
Brief statement of why you need assistance:
Have you previously received assistance from the Ann Arbor Hands-On Museum? Yes/No
If so, when? (month/year)
Have you visited the Ann Arbor Hands-On Museum on a field trip in the last 2 years? Yes/No
When was your last visit (month/year)?
* Indicates a required field.

(Or click here for a printable form to send by mail or fax.)