Indicates required field MEMA Tour/School Visit Request Form This form must be completed for all field trip requests. The average presentation lasts around 30 minutes to one hour. Please keep in mind that in the event of facility activation, your reservation may need to be rescheduled. Thank you.Please fill out all required fields. Type of Tour (required) Please select one of the radio buttons: MEMA Tour (Pearl, MS) MEMA On-Site Visit (Your Location) School Name (required) Teacher Info First Name (required) Last Name (required) Phone Number (required) Email Address (required) GRADE (required) - Select -123456789101112UndergraduateGraduateTechnical Number of Participants (required) Requested Date & Time Please select two options Date Option 1 (required) Date Option 1 (required): Date Date Option 1 (required): Time This date field only allows future dates. Please input the date format as: mm/dd/yyyy. Please input the time format as: hh:mm:ss AM/PM. Date Option 2 (required) Date Option 2 (required): Date Date Option 2 (required): Time This date field only allows future dates. Please input the date format as: mm/dd/yyyy. Please input the time format as: hh:mm:ss AM/PM. Transportation For example: Bus, personal, etc. Number of Vehicles Topic Requests Max length is 2000 characters. Instructions for Visiting School Max length is 2000 characters. Additional Information for visiting MEMA* Please be sure to note any special needs in this field. Max length is 2000 characters. Submit