FIELD TRIP/BUS REQUEST FORM

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:

This is a required question

Destination:

This is a required question

Additional Requested Stops:

This is a required question

Request Date:

This is a required question

Trip Date:

This is a required question

Total Number of People:

This is a required question

Will Transportation be Needed?

This is a required question

Total Number of People Transported:

This is a required question

Number of Buses Needed:

This is a required question

Type of Buses Needed:

This is a required question

Place of Departure or Door Number:

This is a required question

Departure Date & Time:

This is a required question

Return Date & Time:

This is a required question

Chaperones / Teachers:

This is a required question

Estimated Costs to Individual Students:

This is a required question

To be Paid By:

This is a required question

Purpose of Trip:

This is a required question

State the educational goals/objectives that are to be met for each student:

This is a required question

State the number of regular instructional minutes that will be lost for each student:

This is a required question

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.

FIELD TRIP/BUS REQUEST FORM

@ NEOLA 2010 - FORM 2340 F1 & F4