Journey Outreach Booking Enquiry

Name of School *Please enter a value

Address of School *Please enter a value

School Post Code *Please enter a value

Borough or County *Please select a value -- Please Select -- Leeds London: Barking & Dagenham London: Barnet London: Brent London: Ealing London: Enfield London: Harrow London: Havering London: Hillingdon London: Hounslow London: Redbridge Other

If other, please state

School Telephone Number *Please enter a value

Organiser’s Name *Please enter a value

E-mail address *Please enter an email addressPlease enter a valid email address

Year Group *Please select a value -- Please Select -- Year 5 Year 6

Number of pupils *Please enter a value

Number of classes *Please enter a value

Workshop Option *

Workshop 1 only Workshops 1 and 2

Visit date: Preference 1 *Please select a date

Visit date: Preference 2

Visit date: Preference 3

Visit date: Preference 4

What subject are the pupils studying? *Please select a value -- Please Select -- English Geography History Religious Education PSHCE SMSC Other

If other, please state

Details of SEND *Please enter a value

How did you find out about the Centre? *Please select a value -- Please Select -- Facebook Twitter Educational Visits UK UK School Visits SACRE Direct Mail (Letter) Word of Mouth Conference Instagram AJR Northwood & Pinner Liberal Synagogue Heads & Chairs meeting Other

If other, please state

GDPR

Do you give permission for the National Holocaust Centre and Museum to contact you in the future regarding events, learning programmes and offers? *Please select a value -- Please Select -- Yes No

What is your preferred method of communication? -- Please Select -- Post E-mail

Would you like to be added to a mailing list to receive a copy of our newsletter? *Please select a value -- Please Select -- Yes No