KPSVA Activity Request
Type of Activity *
Title of Activity *
Your answer
Staff Contact *
Your answer
Parent Contact
Your answer
Name of Organization *
Your answer
Total Number of Students and/or Parents Expected *
Your answer
Cost per Attendee *
Required
Event dates
MM
/
DD
/
YYYY
Start Time: *
Time
:
End Time: *
Time
:
Event Location
Will Security(**) be needed? *
** Note Teacher is Responsible for Providing Field Trip Forms to all students prior to off campus event
Will Students miss lunch? If which one? *
If students need sack lunches, how many ?
Your answer
For events outside of lunch hours, will the kitchen facilities be used?
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