JCHS Education Committee
Educational Aid Application Form
For assistance with the museum classroom visit fees and transportation assistance (Jefferson County schools only)

Teacher(s) name_______________________________________________
School_______________________________________________________
School phone number___________________________________________

Visitation Date_________________________________________________
Arrival time ___________________Departure time________________

Field trip location (check one) Museum______ Rothschild House______

Grade level of students___________________________________________
Number of students________________ Number of adults_______________

Requesting Assistance with:
Admission Fees___ Waived____ Transportation______________
Amount needed_____________________________________

Return completed form by mail, in person, or email to:

Jefferson County Historical Society
540 Water Street
Port Townsend, WA 98368
 360-385-1003