Virtual Animal Experience Request Form Education Request Form - VIRTUAL Behind the Scenes Experiences This is a REQUEST only--we will contact you to finalize details or discuss alternate dates. Requests must be made at least 3 days prior to your visit. Please make sure you see a confirmation screen indicating your form has been submitted successfully. If you have any questions feel free to call 520-837-8200 or email firstname.lastname@example.org Today's date* Date Format: MM slash DD slash YYYY Your Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How many people will be watching this program?*What is the age range of the participants?Please select an experience*Animal Ambassador EncounterPlease note: You will be contacted by staff to confirm your program within 24 hours of your request. Payment must be received 24 hours in advance of your confirmed date. Each program is 20 minutes and $30. Please list your top three date choices (use the "+" to add dates)* PLEASE ADD UP TO TWO ALTERNATE DATES as experiences are booked based on availability. Reservations must be made at least 3 days in advance of requested dates. Programs are available 7 days a week. Preferred Start Time? Programs must begin after 8 am MST-AZ*What Time Zone are you in?*Available Technology - please select an option for video AND audio Yes, I will have a webcam and can share my video during the program. No, I do not have a webcam. Yes, I can share audio through my computer, laptop or other microphone. No, I will not be able to share audio during the program. Please assist us in planning for your program by checking which technological features will be available to you during your program. (Having a webcam and/or microphone is preferred to improve the interaction between you and the educators but is not required). Additional questions or notes for Zoo staff?