Student Matinee Ticket Form Requested By Teacher First Name: * Teacher Last Name: * Teacher E-mail Address: * Teacher Direct Phone: * Teacher Cell Phone: Billing Information School Address * City * State * Zip Code * Billing Contact First Name * Billing Contact Last Name * Billing Contact Address * Billing Contact Phone Number * School Information Select your state below and you will be presented with a list of public school districts and schools to choose from. If your school is not included in this list, tell us about your school in the Comments or Questions section at the bottom of this application so we can process your request. State: * Kansas Missouri County * KS - Johnson County KS - Wyandotte County MO - Clay County MO - Jackson County MO - Platte County District * School * Performance Information We would like to request tickets for the following performance: * 2017-4/4 - National Geographic Live! Anand Varma, Beauty and the Bizarre - 10:30AM Tuesday, April 4, 2017 If you would like to purchase tickets to more than one of the performances, please submit a separate form for each performance to plan to attend. How many students will attend the performance? ($2 per ticket): * From what grade(s)?: * Please list the grades of students who will attend this performance. How many adults will attend the performance? ($2 per ticket): * We want to maximize the number of students who are able to benefit from this educational experience. Please request only the minimum number of adult tickets you need for appropriate chaperoning of your students - we suggest no more than 1 adult for every 8-10 students. Comments or Questions Let us know about any special requirements your group may have, or if you have any other questions or comments: Let us know about any special requirements or seating needs your group may have, or if you have any other questions or comments: Email Opt In YES ‐ Please add me to the Education Email List so I can receive information about upcoming education opportunities at the Kauffman Center.