Hands on History - Special Education Request Form

November 13

History Through the Senses: A Special Education Day at Brentsville Courthouse Historic Centre

10:00 a.m. –12:30 p.m.; $10 per student; Fill out the registration form below and submit to register.

Families and educational groups are invited to visit Brentsville Courthouse Historic Centre for an inclusive day of learning about American History! Rotate through stations focusing on hands-on activities as you explore American history through smell, touch, taste, feel, and sight. This program can be tailored for the autism and LD classrooms. Brentsville Courthouse Historic Centre, 12229 Bristow Rd., Bristow, VA. 703-365-7895.

Hands on History:

Connects students to their local history through place-based learning
Includes interactive, hands-on opportunities for students to learn the craft of history firsthand
Fulfills History and Social Science Virginia Standards of Learning

1. School/Group Name *This question is required.

2. Age Group/Grade Level *This question is required.

3. School/Group Address *This question is required.

4. # Students Attending ($10.00 per student) *This question is required.

5. # of Chaperones (Free) *This question is required.

6. Group Leader Name *This question is required.

7. Group Leader Cell Phone *This question is required.

8. Group Leader E-mail *This question is required. This question requires a valid email address.

9. Allergies (please type N/A if none) *This question is required.

10. Description/Definition of Group's Special Needs (please type N/A if none) *This question is required.

11. Additional Information

12. Do you need to request any specific accommodations?

Not sponsored or endorsed by PWCS.