SASD Field Trip/ Transportation Request
A separate form will need to be completed for each Field Trip requested, even if the purpose is the same.
Email address *
By checking "Yes", I am stating that I have read SASD Board Policy #121, and will adhere to all guidelines set forth in this policy. (Policy can be found on www.southallegheny.org under School Board>Board Policy Manual>100 Programs) *
Required
Requested by *
Your answer
Date of Field Trip *
MM
/
DD
/
YYYY
Purpose of Trip *
Describe Trip *
Your answer
Building *
Destination and specific address *
Your answer
Grade level(s)/ Organization *
Your answer
Number of Students Participating *
Your answer
Transportation Request *
Number of buses requested *
Your answer
Students will leave the building at *
Time
:
Specific Pick-Up Location *
Your answer
Students will return to the building at *
Time
:
Specific Drop Off Location *
Your answer
If applicable, please describe plans for lunch, including time and if transportation will be needed to lunch location.
Your answer
Teachers/ Chaperones/ Coaches Attending *
Your answer
Substitutes Needed/For Whom *
Your answer
Is this field trip being sponsored by a team, company, or organization? *
Who is responsible for remitting payment? Please include name, address, and/or email. *
Your answer
What, if any, are the anticipated costs to the District? (including substitute costs) *
Your answer
What, if any, are the anticipated costs to the student and/or parent(s) or guardian(s)?
Your answer
What practical safety and security provisions have been established? What is the plan for communicating this to all who need to know? *
Your answer
What arrangements have been made in the event of a cancellation of the field trip? (Cancellation insurance, notification of parents, refunds or other?) *
Your answer
By checking this box, you are stating that appropriate parties will be notified and permission slips will be secured prior to attending the trip. *
By checking this box, you are stating that you will return to the building by 2:00pm at the latest. *
If requesting the District van, by checking this box, you are stating that you are an approved driver for the District.
Any additional comments or information
Your answer
In order to verify your transportation when provided by PA Coach, please contact PA Coach at (412) 872-4936 before 6PM. Evenings and weekends call (412) 896-9880 or (412) 583-3278.
A copy of your responses will be emailed to the address you provided.
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