Lesson for Pre-Kindergarten: Paint and Play Request Form

Contact Information

Primary Contact Name*

First Last

Primary Contact Email*

Primary Contact Phone Number*

Additional contact name(s)

Additional contact email address(es)

School/Center Name*

School District (if applicable)

Address*

Street Address Address Line 2 City State Zip Code

Cost Information

inStill has a cost of $6/student. Teachers and chaperones are included. The cost is waived for programs that receive Title 1 or Head Start funds. Additional scholarships are available.

Number of Students Attending*

Number of Teachers/School Staff Attending*

Number of Chaperones Attending*

Choose Your Cost*

Standard cost: $6/student
Cost waived: My program receives Title 1 or Head Start funding.
Scholarship Requested: My program does not receive Title 1 or Head Start funding, but needs a scholarship.
Virtual: No cost

If you do not receive Title 1 or Head Start funding and are requesting a scholarship, please describe your needs below.

Scheduling

When would you like to visit? Let us know if you have specific dates in mind or if you are flexible within a certain week or month.*

inStill Experiences are available Tuesday–Friday between 9:30 a.m. and 1:30 p.m. inStill is not available on Mondays.

Paint & Play is a 3-part lesson. Please select the lesson sections you are interested in*

Option 1: Experimenting with colors (classroom)
Option 2: Experimenting with colors (classroom) and exploring abstraction (classroom or Museum)
Option 3: Experimenting with colors (classroom), exploring abstraction (classroom or Museum) and playing with paint (in the classroom)

If you selected Options 2 or 3, would you like your second visit to be in the classroom or at the Museum?

In the classroom (30 minutes)
At the Museum (90 minutes)

Would you like us to send you a package to help prepare your students for your experience containing plushies, some of our favorite books, and ideas for pre- and post-experience activities? There is no additional cost for the preparation package.

Yes
No

Tell us about your students!

How does this visit fit into your curriculum? What have you been working on?*

What kind of background knowledge or schema will students bring to this experience?*

Have students visited a museum or another cultural site before? What kinds of art experiences (both looking and making) have they had?

What brings your students joy?*

This might be a conversation topic, a classroom norm or routine, a piece of media or culture-anything! We’ll use this info to help us build rapport with students and to make connections to things that are familiar.

The Clyfford Still Museum welcomes students and educators with disabilities. We work closely with our community to ensure that individuals with disabilities can fully participate in our programming. We provide an array of inclusive programming, offer educational support upon request, and strive to customize your museum experience to fit the needs of all learners.

How many of your students identify as having a disability?

A person with a disability is someone who has a physical or mental impairment that substantially limits one or more major life activities, has a history or record of such an impairment, or is perceived by others as having such an impairment. This helps us with the funding and planning of our programs and will not be shared.

Which accommodations would support students in your group?

Noise-canceling headphones
Tactile materials
Sensory fidgets
Visual instructions
ASL interpretation
1:1 educator support
Wheelchair use

Do any of your students primarily speak a language other than English? If so, which language(s)?

We can provide bilingual support or lessons in Spanish pending bilingual educator availability.

Is there anything else you want us to know at this time?

How did you learn about this program?*