George Nakashima: One With Nature
Registration Form

The Resource Kit can be rented for up to a 2 month period or for a One Day Program. Transportation of the kit to and from the school is not included. Cost: $75 a month rental fee. $100 Security Deposit (Refundable if no items are returned damaged or missing.) $75 optional fee for a Museum educator to visit the classroom and provide an introductory lesson on George Nakashima. One-Day Program rental available for $100, which includes Kit and Educator for one class. Terms of Rental: Payment is due prior to rental. Renter assumes responsibility/ liability for kit's contents.

Mail registration form and check to:
Adrienne N. Romano, Associate Curator of Education
James A. Michener Art Museum
138 South Pine Street
Doylestown, Pennsylvania 18901
Phone 215.340.9800, x111 Fax 215.340.9807

Please make check payable to the James A. Michener Art Museum

Nakashima Resource Kit Registration Form:

Name: ________________________________________________


School: ______________________________________________


School District: _____________________________________


Address: _____________________________________________


City: __________________ State: ______ Zip:___________


Phone:____________________  Fax: _____________________


Dates interested:
1st Choice: _____________  2nd Choice: _______________


3rd Choice: ___________ Museum Educator? yes___ no ___


Check #: ________________ Fee Enclosed: ______________


Signature of person responsible for trunk:

______________________________________________________

Renter assumes responsibility/liability for trunk contents.
Penalty fee will be incurred if materials are returned damaged or missing.