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Schedule a Virtual Outreach Program

If you would like to schedule a virtual outreach program with the MSU Museum, please fill out and submit the request form below. Please give us two potential program dates and times (in EST). Program requests must be made a minimum of three weeks in advance. If you are not contacted within 1-2 business days after submitting your request form, please contact us at (517) 432-1472 or Email

Program Registration (Pick top two date and time choices.)
Program Title *
Trip Date 1   (m/d/y) / /
Trip Time 1   (h:mm am/pm) :
Trip Date 2   (m/d/y) / /
Trip Time 2   (h:mm am/pm) :
Teacher Name *
Teacher E-mail *
Class Grade
Number of Students
School Name
School Address
School City, ST  Zip
School County
School Phone Number
 )   -   ext 
School Fax Number
 )   - 
Technical Information
IP Address                                        . . .
Connection Speed MBps
Video-Conference Room Phone Number
 )   -   ext 
Technician Name
Technician Phone Number
 )   -   ext 
Technician E-mail
Do you have any special concerns or needs?
If yes, please describe.