M I S S I O N   M I L L   M U S E U M
School Tour Request Form
Please complete this form, print and mail, or fax to 503-588-9902
Please enter tyour name here:
Street address:	City:  ST:  Zip:
Suite # or PO Box:	Email address:
Phone number:
Number of Students/Age or Grade:	Number of Chaperones (1:5):
Preferred day of week:	Time (10 a.m. - 4 p.m.):
First choice of date:	Second choice of date:
We plan to tour the Houses:	We plan to tour the Woolen Mill:
We are requesting an Activity: Pioneer LifeSchool DaysFiber to FabricThe KalapuyansWater Power #1Water Power #2Pioneer ChristmasNo Activity	We plan to eat lunch on the grounds:
Comments: Please let us know how we can complement your curriculum as well as any special needs your group may have.
Please print this form and fax to 503-588-9902

Mission Mill Museum Association 1313 Mill St SE Salem, OR 97301 Contact us at (503) 585-7012 or missionm@teleport.com