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Portable Dome
Portable Planetarium Reservation Form
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Portable Dome Reservation Confirmation
This form is for requesting the portable planetarium to visit your school/organization or event and is only a request and
not a confirmation
. The Planetarium coordinator will contact you with more information and to confirm on date and times and / or any special requests. Please make sure that you have the required space available before you fill this form out.
Name of School or Organization:
Primary Contact Name:
Phone #:
Email:
Date of visit (1st choice):
Optional visit date (2nd choice):
Special Request / Accommodations:
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