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Distance Learning Online Reservation Form



The fee for Ohio schools / groups is $50 / presentation; out of state schools / groups is $125 / per presentation.

The full fee will be charged to sites which cancel with less than 24 hours notice.

We will not charge for presentations that are cancelled due to inclement weather.

All fields are required.

  1. Today’s Date:

     
  2. Requested Presentation:

     
  3. Requested Date:

     
  4. Alternate Date:

     
  5. Start Time:

     
  6. End Time:

     
  7. Site Name:

     
  8. Street:

     
  9. City:

     
  10. State:

     
  11. Zip Code:

     
  12. Phone Number:

     
  13. Fax Number:

     
  14. Bill Presentation To:

     
  15. Attn:

     
  16. Street

     
  17. City:

     
  18. State:

     
  19. Zip Code:

     
  20. Phone Number:

     
  21. Fax Number:

     
  22. Contact Name:

     
  23. Contact E-mail:

     
  24. Number of Students:

     
  25. Grade Level:

     
  26. Technician Name:

     
  27. Technician Phone:

     
  28. IP/ISDN/ATM Number:

     
  29. Technician E-mail:

     
  30. Type of Connection:
    (Schools are responsible for any line/bridging charges)
  31. Line Speed:

     

Special Instructions:

If your requested dates are unavailable, you will be contacted to discuss alternative dates. An e-mail based confirmation will be sent once your program has been entered into our scheduling system. 

Payment is due upon completion of program.

If you have questions, please contact our studios at 614.298.2965 or toll free at 1.800.640.7679, or by email at dl@ohiohistory.org.