Field Trip Form Rev. 4.2022

FIELD TRIP REQUEST

Please complete the following form to request approval for a field trip.
Requester's Name*
Person listed has ultimate responsibility for the trip
Date of Request*

MonthDayYear
Date
Which building are you associated with?*
Email
example@example.com
What is your school email address?*
example@example.com
Group Taking the Trip*
Date(s) of Trip:*
Name of business or facility you are planning to visit (eg The Indianapolis Zoo)*
Street Address of Destination: (Be Specific)*
City of Destination*
Destination State*
Fee Charged per Student*
Specific Amount Paid
Number of Students*
Number of Chaperones*
Total Number Being Transported*
Grade Level of Students being Transported*
Indicate all grades
Number of Students Absent From School Lunch*
During School
Do you want school lunches for your group?*
Total School Lunches Requested*
(Include Drivers)
Out-of-State Field Trip:*
Is this an overnight field trip?*
Will substitute teachers be needed?*
Please indicate None, Whole Day, or Half Day
Please Request the Number and Type of School Buses (The number indicates capacity with 3 students to a seat)

An administrator will have the ultimate responsibility for assigning the number and size of buses
Large Bus w/ Luggage
84 passengers with 3 students per seat
Regular School Bus
72 passengers with 3 students per seat
Wheelchair Bus
54 passengers w/ wheelchair
Activity Bus
Limited to 14 passengers
Departure Location*
Use Door Number or East/West Side of Building
Departure Time*

Hour Minutes

AM/PM Option
Return to Location*
Use Door Number or East/West Side of Building
Return Time*

Hour Minutes

AM/PM Option
School Rep's Name that will have a cell phone*
School Rep's Phone Number*

Area CodePhone Number
Site Contact Name *
Site Contact Telephone Number *

Area CodePhone Number
Activity Description*

0/250
Signature*

Clear
Date*

MonthDayYear
Date
NOTE: All field trips outside the state or overnight must be approved by the Board of Education.
Should be Empty:

FIELD TRIP REQUEST