School or Group Request for Program

Please complete and submit this form to request your program and date(s). We will contact you to confirm the details of your visit upon receipt. 

Contact Information

To be used for day of program.

Group Information


Arrival and Departure Time

Please tell us when you expect to arrive and when you need to depart.

Date Options

Please give us 3 dates that would work for you. We'll do our best to accommodate them in the order listed.


Photography Permission

By checking the box below you authorize the Lake Champlain Maritime Museum to photograph and/or videotape your students for publicity purposes. If you do not want your students to be photographed, please uncheck the box and submit the form.

Program Options

Please choose a program. We're happy to work with you to develop a program tailored to fit your needs. If this is something you're interested in, please choose the Custom Programming from the list in the dropdown.