Traveling Trunk Registration Form

The Traveling Trunk can be rented for up to a 2 month period.
Transportation of the trunk 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 introduction and brief history of Pennsylvania Impressionism. $100 One-Day Program Fee only (includes Trunk and Educator for one class)

Terms of Rental:
Payment is due prior to rental. Renter assumes responsibility/ liability for trunk 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

Traveling Trunk 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:

______________________________________________________