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Program Request Form

Zoologist Joel Vanderbush presents a Red-tailed hawk. Photo provided by Indiana State Museum.

Zoologist Joel Vanderbush presents a Red-tailed hawk. Photo provided by Indiana State Museum.

Client Name (required)

Program Site Address (required)

City (required)

State (required)

Zip (required)

Program Site Phone

Contact Person Name (required)

Contact Person Phone (required)

Contact Address (if different from Site Address)

City

State

Zip

Contact Person e-mail (required)

Alternate Phone

Program Details

Program Type:

     


     


     

Program Date(s) (required)

Program Time(s) (required)

# of Programs (required)

Program Title(s) (see program list)

Participant Age Range

# of Participants

Animals
You can choose up to 5 species of animals your group would enjoy from the list below or Animalia can choose based on the most popular animals for your group’s age.

  • Mammals: Ferret, Rat, Chinchilla, Degu, Prairie Dog, Hedgehog, Skunk, Raccoon, Opossum, Kinkajou, Cat, Dog
  • Birds: Umbrella Cockatoo, Blue and Gold Macaw, Mealy Amazon Parrot, Barred Owl, Red-tailed Hawk, Red-shouldered Hawk. Please note that only the Cockatoo is touchable.
  • Reptiles: Iguana, Blue-tongued Skink, Water Dragon, Plated Lizard, Geckos (Leopard, African Fat-tailed, Tokay), Snakes (Ball Python, Boa Constrictor, Dumeril’s Boa, Corn Snake, Milk Snake), Tortoise (Egyptian – very small, Spur-thigh – very large)
  • Invertebrates (Bugs!): Madagascar Hissing Cockroach, Tarantula

Bonus Features (See program description for details)

  •  Gifts for Animals
    Participants can donate items to the animals of Animalia to assist with their care. To learn about the items Animalia needs, see the program description.
  • T-shirts ($15 each):
    Quantity:
    Size(s):
    Color(s):
    Design:
  • Posters:
    Windows to the Soul - 5 ½ x 17 in. = $5
    Faces Only A Mother Could Love -11 x 17 in. = $10
  • Activity/Coloring Sheets:
    # of sets:
    A descriptive animal coloring sheet on front and an age appropriate activity on the back. For only $15, Animalia will provide a set for up to 25 people (for more than 25, add additional sets).

How did you hear about Animalia?

   What event?
  By Whom?
   





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