Important: If field trip/bus request is for overnight travel or out of state, the field trip/bus request must be approved by the school board. Please allow additional time for approval.
Teacher or Person Requesting: *
Destination: *
Additional Requested Stops: *
Request Date: *
Trip Date: *
Total Number of People: *
Will Transportation be Needed? *
Total Number of People Transported: *
Number of Buses Needed: *
Type of Buses Needed: *
Place of Departure or Door Number: *
Departure Date & Time: *
Return Date & Time: *
Chaperones / Teachers: *
Estimated Costs to Individual Students:
To be Paid By:
Purpose of Trip:
State the educational goals/objectives that are to be met for each student:
State the number of regular instructional minutes that will be lost for each student:
I have utilized the guidelines in 2340A to plan, conduct, and evaluate the trip and, upon approval of the trip, I will obtain parental permission and use the trip checklist.

The staff member in charge will have a COMPLETED EMERGENCY MEDICAL FORM for each student on the trip.

If field trip/bus request gets cancelled, I will notify the Principal and Transportation Director as soon as possible. Failure to notify of cancellation or changes may result in a fee to the building or organization.
@ NEOLA 2010 - FORM 2340 F1 & F4
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