Special Services Field Trip Request Form 2019-2020
This form is to be utilized when requesting a field trip. Large buses fit 42 passengers, white van fits 9 passengers. Each wheel chair means 6 less passengers.
Email *
District *
Site *
Staff Requesting Trip *
Program *
Date of trip *
Destination(s) (include if there is a lunch stop planned) *
Address of Destination(s) (include if there is a lunch stop planned) *
Phone Number of Destination *
Pick up Location (What door or entrance, i.e. main, gym, etc) *
Number of students *
Number of staff (Name of staff in charge and cell phone number) *
Configuration (Any wheel chairs, car seats or harnesses) If so how many? *
Departure Time (When does the bus need to be at your school) *
Return time (When does the bus need to be back at your school) *
Is there a parking fee for the bus? How much? *
Cost per student *
Cost per staff *
Total Cost *
Purpose of the trip (Educational Objectives) *
Do not fill out below this area: (Administrators only)
Principal's Approval
Clear selection
Superintendent's Approval
Clear selection
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