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CHIME School Visit Request Form

School/affiliation:
Name of individual arranging visit:
Best Contact Phone:
Best Email Address:
Street Address:
City:
State:
Zip Code:
How many in your group?
School visits are typically most effective in teams prepared to return to their school to implement new ideas. We have found that visits including a variety of stakeholders (such as special education teachers, general education teachers, administrators, and parents) have found the most success following their visit, and we will give priority in scheduling these groups. Please list the roles of the members of your group:
Most visits include a variety of grade levels, and a visit to a particular grade level is not guaranteed, due to grade level activities and field trips. However, we will do our best to accommodate your interests. Please indicate the grade(s) in which you are most interested in observing (K-8):
Most organized group visits are scheduled for 2.5 hours, from 9:00 to 11:30, and include an overview of the school and its programs, classroom visits, and a debriefing/Q & A period. Visits consisting of 1-2 people may be shorter in length. Will this time frame meet the needs for your visit? (yes/no) (if no, explain)
All visits are arranged at least 3 weeks in advance, and are typically held on (Tuesday and Thursday), but may require a longer wait during busy times of the school year. Specify days & times available, beginning three weeks after today’s date:


Longer visits can be arranged for a nominal fee to offset time spent by school staff (please arrange directly with school staff)


What is the purpose of your visit?
Other specific requests related to your visit:

Click here to create your own form.
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Imagine a world where all children are equally valued, a world where all children are seen as a gift.
CHIME Early Childhood
Infant/Toddler Program
Tel: 818-677-2922
CHIME Preschool
Inclusion Program
Tel: 818-677-2922
CHIME Institute's Schwarzenegger
Community School
Tel: 818-346-5100