Field Trip Application
School Year 2019-2020
Important
Please keep in mind that it takes about three (3) weeks to get a check out to vendors. Please submit your request in advance so we may guarantee the check reaches the vendor in time.
Teachers Name
Your answer
Grade *
Room Number *
Your answer
Trip Destination *
Your answer
Date of Trip *
Please list three dates in order of preference
Your answer
Educational purpose of trip *
Your answer
Name of Program chosen *
Your answer
Cost per student *
Your answer
Permission Slip Needed by: *
Give date 2 weeks prior to trip
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How many students are going on this field trip? *
Your answer
Name of each student with medical condition and their needs: *
Your answer
Contact information for site reservation, ticket purchase and/or bus parking reservation: *
Please provide name and phone number
Your answer
Do you need transportation? *
Departure time: *
Time
:
Return pick up time: *
No later then 1:15 pm
Time
:
Number of chaperones needed *
Usual requirement is 1 chaperone per 10 students; some require 1 to every 5 students.
Chaperone Fee *
Your answer
Arrival time for Chaperone *
Time
:
Special Chaperone Directions
Your answer
Student Attire *
Required
Lunch *
Cost of site/trip *
Give total cost
Your answer
Is a deposit required *
Amount of deposit required
Your answer
Due date of payment *
Please be exact
MM
/
DD
/
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Form of payment accepted *
Reminder that it takes about 3 weeks to get a check
Your answer
Additional info *
No electronics allowed on trips. No cell phones. Chaperones may not bring siblings/younger children .
Required
An confirmation will be sent to you once the trip has been scheduled and confirmed *
Comments
Your answer
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