History Take Out Request Form

For educational groups looking to book a facilitated program in your own classroom in the Denver metro area during the 2023-2024 school year.

Cost: $75 per class (maximum 30 students per class) + $15 travel fee. Title I schools $60 per class.

The School Programs Manager will be in touch within 5-7 business days to schedule your History Take Out. If you have questions, please contact Josie Chang-Order at josie.chang-order@state.co.us (preferred) or 303-866-3345.

History Take Outs are not available from History Colorado Center during the summer. If you would like to connect with a partner organization who has the Ute Knowledge History Take Out during the summer, please contact Josie.

1. School Name

2. Street Address

3. City / State / Zip

4. School District

5. Main Office Phone Number

6. Does the school qualify for Title I status?

7. Lead Teacher's Name

8. Lead Teacher's Email

9. Email Addresses of All Participating Teachers.

Planning for your History Take Out

Duration: 60 minutes (or 40 minutes for ECE and Kindergarten classes).

*Please note a central feature of the program is a large 7’ x 9’ map of Colorado that students will sit around.*
We prefer being in either a gym, cafeteria, or a classroom with desks moved out of the way.

No audio/visual equipment is needed.

10. Select your desired History Take Out program.

11. Grade Level

The History Take Out Programs are primarily designed for 3rd and 4th grade but can be adapted for other grade levels.

12. Number of Classes

Please let us know how many classes will be participating in the program (1 class per hour-long session). We can typically facilitate up to 5 programs within one day.

13. Approximate Number of Students Per Class

Minimum 10 participating students per class; maximum 30.

Scheduling Your History Take Out

Please list the time or schedule for the day and select a date from September to May for your History Take Out Program.

History Take Outs are not available from History Colorado Center during the summer. If you would like to connect with a partner organization who has the Ute Knowledge History Take Out during the summer, please contact Josie.

14. We prefer to stay in one location and have classes rotate through to reduce setup/breakdown time. Ideally classes can be back to back, but we are okay with breaks between classes as needed. Please provide us specific times or schedule outline for the day of the program(s).

15. First preferred date
(Earliest available date is September 20. Latest available date is May 24.) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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16. Second preferred date This question requires a valid date format of MM/DD/YYYY.

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17. Third preferred date This question requires a valid date format of MM/DD/YYYY.

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18. Where should our facilitator park?

Please enter an 'other' value for this selection.

19. Additional Details

Other details that could help us plan for your History Take Out program? (e.g., students with disabilities that require accommodations, ESL students that need extra support, etc.)