FIELD TRIP and/or TRANSPORTATION REQUEST
IMPORTANT: ALL trip requests must be submitted far enough in advance to allow for consideration and approval of the Principal, then the Superintendent, then the Board (for any overnight or out-of-state (not incl. Louisville) trips, approval of the Board is required at a regular Board meeting).
School
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JES - Johnson Elem
LES - Lexington Elem
SES - Scottsburg Elem
VFES - Vienna-Finley Elem
SMS - Scottsburg Middle School
SHS - Scottsburg High School
ELA - Early Learning Academy
Destination & Purpose of Trip:
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Date of Trip:
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Month
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Day
Year
Date
Will this trip occur during the school day/time?
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NO, not during school hours
YES, during school hours
Trip DURING School Hours
This section is required if a requested trip will occur during school hours
Scheduled start time of first activity or event at destination:
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:
Hour
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05
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30
35
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55
Minutes
AM
PM
AM/PM Option
List the specific educational objective(s) of which this trip will facilitate the attainment:
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List the course or subject area associated with this trip:
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Identify the unique educational opportunity this trip will provide for participating students:
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Explain why this trip cannot reasonably occur without interrupting the school day:
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Acknowledgement Needed:
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I understand permission slips signed by guardians are required when students are leaving the school property during school time and I will meet that requirement (See your Principal with any questions about permission slips).
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Student & Adult Participant Details
These are important details and need to be as accurate as possible
Select EACH grade level of students participating in the trip:
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K and/or PreK
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Number of STUDENTS participating in trip:
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Number of ADULTS participating in trip (sponsors/chaperones):
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Sponsor/Teacher NAME (Who is the primary supervisor of the trip?)
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First Name
Last Name
Sponsor cell phone #
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-
Area Code
Phone Number
Sponsor/Teacher EMAIL (for approval notifications)
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myexample@scsd2.k12.in.us
Name(s) of ALL additional sponsors or chaperones participating (comma-separated):
*
Be mindful of completed background checks of volunteers/parents
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Are you requesting one or more buses for this trip (Either mini or full size bus)?
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YES
NO bus of any kind is needed
TRANSPORTATION REQUEST
These details are important as they will be used by the Transportation Dept if the trip is approved.
Number of MINI-BUSES requested:
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NONE
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6
Capacity: 14 passengers + 1 driver
Number of FULL SIZE BUSES requested:
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NONE
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Capacity: Approximately 60 small people; Approximately 45 larger people
DAY and TIME of DEPARTURE
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Month
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Day
Year
Date AND Time Required
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Minutes
AM
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AM/PM Option
Departure Location:
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Example: School bldg name, door #, etc.
Name/Address of DESTINATION:
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Example IUS Library, 4201 Grant Line Road, New Albany, IN
DAY and TIME of RETURN
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Month
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Day
Year
Date AND Time Required
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Hour
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Minutes
AM
PM
AM/PM Option
Return/drop off Location:
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Example: School bldg name, door #, etc.
Principal Approval
Do NOT approve if there is not sufficient time for all required approvals AND for bus drivers to be scheduled, if needed. Requests approved by the Principal are forwarded for the Superintendent's approval. If this trip is overnight or out-of-state and is approved by the Principal, and then the Superintendent, it must be approved by the Board before the date of the trip.
Does the Principal APPROVE this request?
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APPROVED
NOT APPROVED
REASON the Principal does NOT approve this request:
*
This will be sent to the Sponsor/Teacher submitting the request and an EDIT LINK will be included in their notification so they may re-submit with different information, if applicable.
Principal's Name
*
First Name
Last Name
Principal's EMAIL address (for approval notifications)
*
myexample@scsd2.k12.in.us
Principal's Signature
SUPERINTENDENT ONLY: Click the checkbox below to open the SUPT ACTION Section.
Open Supt Section
SUPERINTENDENT ACTION
Does the SUPERINTENDENT APPROVE this request?
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APPROVED
NOT APPROVED
REASON the SUPERINTENDENT does NOT approve this request:
This will be sent to the Sponsor/Teacher submitting the request and an EDIT LINK will be included in their notification so they may re-submit with different information, if applicable.
Does this request require Board approval?
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YES
NO
Superintendent's Signature
*
ADMIN ASST of SUPT: Click the checkbox below to open the BOARD ACTION Section.
Open Board Action Section
BOARD ACTION
Did the BOARD APPROVE this request?
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APPROVED
NOT APPROVED
Date of Board Action
*
-
Month
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Day
Year
Date
TRANSPORTATION DEPT: Click the checkbox below to open the TRANSPORTATION Section.
Open Transportation Section
TRANSPORTATION DETAILS
Name(s) & Phone # of Bus Driver(s)
*
MINI-BUS(ES) ASSIGNED, If applicable:
Email notifications to submitter
*
Yes, email notifications are enabled
No
Preview PDF
SUBMIT
Should be Empty: