Off-site Form

Name

Project

___________________________ ___________________________

Date and Destination

Today’s date _______________________    Date you will be offsite ______________________

Fieldwork destination ___________________________________________________________

Departure time __________________________  Return time ___________________________

Purpose/Goals

What will be accomplished? _____________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________

Transportation/Supervision

How will you get there? _________________________________________________________

Mentor/Chaperone(s)  __________________________________________________________

Contact Information:  Phone: _____________________________________________________

                        Address: ___________________________________________________

Approval

Parent Signature _______________________________________  Date __________________

Advisor Signature _______________________________________ Date __________________