<p> MADlab Reservation Form</p><p>Type of Tour: TITLE ONE SCHOOL</p><p>Reservations are available for MADlab tour and workshop at 10:30AM, 1:00PM and 3:30PM. </p><p>MADlab Date: ______Time:______</p><p>Group Type: ___K-12 students ___Special Needs</p><p>Grade level: ____ # students in group: ____ # chaperones: ____ </p><p>______CONTACT NAME</p><p>______SCHOOL FULL NAME AND NUMBER</p><p>______ADDRESS</p><p>______CITY STATE ZIP</p><p>______WORK PHONE: HOME PHONE:</p><p>CELL PHONE:______FAX NUMBER :______</p><p>EMAIL ______</p><p>Comments:______CreditCard#:______ex:______CVV#:______Note: A valid credit card is necessary to secure your tour date. Your card will only be charged if you do not allow sufficient notice for cancellation; 10 days or less your card will be charged $50, less than 24 hours notice your card will be charged the full cost of the tour, $105. Free Museum tours for Title One schools, made possible by the Fondation d'entreprse Hermès, with additional support from HSBC Bank USA, N.A.</p><p>Date: __/__/__</p>