MMOT Reservation Request

If you would like to request the MMOT to visit your school or community please fill out the form below.
If you would like to request a Guest Speaker to visit your school please CLICK HERE.

Reservation Request Form

"*" indicates required fields

*** Please note the MMOT Bus is ONLY available to travel within the state of Illinois. The MMOT Extension Combat Hate: A Digital Media Literacy is available in-classroom and MMOT Extenstion Guest Speakers are available virtually on a global scale. ***

How did you hear about us?

Name*

Prefix First Last

Email Address:*

Contact Phone Number*

Organization Name:*

Occupation Title:

Organization Address:

Street Address Address Line 2 City State ZIP Code

Organization Type:*

Program Preferences

Please choose the program choice for the MMOT below. You may select more than one. Programs and Workshops will be offered based on availability. If you are unsure about a specific workshop(s) you would like for your students to experience, please select the last choice.
If you are requesting the MMOT for a community event or business, please select the option below. Thank you.

Program or Workshop requested:

Date(s) Requested

Please list the date(s) you are requesting to host the MMOT and any other additional information

Additional Information or Requests: