Eckley Explorers Reservation Form

Contact Name *

Phone *

Email Address *Please be sure to double-check email addresses for accuracy as status notifications will be delivered via email.

School *Only schools are eligible for the CCX Transportation Scholarship.

School District *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Title-I Eligible *Title-I eligibility is not required, but Title-I eligible schools will receive precedence.

Pickup Date *

Return Date *

Kits may not be borrowed for more than one school week.

Kit Preference

Kit 1: Patchtown DaysKit 2: The Pennsylvanian Period (coming soon)Kit 3: Push-Pull PassportKit 4: Labor History (coming soon)Please choose the grade level used for:

Grade Level Use

Pre-KK-2Grade 3 - 5Grades 6 - 8Grades 9 - 12Please choose the grade level used for:

Do you require free round-trip shipping? *This subsidy is subject to approval. Preference is given to schools outside a 25-mile radius.

Acknowledgement: I understand that I am responsible for the contents of the kit. I also agree to return the kit by the due date. I understand that multiple late returns and damage to kit contents may result in suspension of use. *

Yes.