Online Overnight and/or Out of State Trip Request Form

Overnight and/or Out of State Trip Request

Clark County Public Schools
Submission Date

MonthDayYearHourMinutesAM/PM Option
Board Meeting Date

MonthDayYear
Date Approved By SBDM

MonthDayYear
Administrator Making Overnight/Out of State Request:

First NameLast Name
Administrator's E-mail Address:
Your E-mail Address
School/Department:
Overnight/Out of State Agenda Item Request:
Organization:
Grade, Team, Club
Teacher/Coach/Sponsor:

First NameLast Name
Teacher/Coach/Sponsor Contact Number:

Area CodePhone Number
Teacher/Coach/Sponsor's E-mail Address
CHECK ALL THAT APPLIES:
Departure Date:

MonthDayYear
Departure Time:

:HourMinutesAM/PM Option
Departure Location:
Return Date:

MonthDayYear
Return Time:

:HourMinutesAM/PM Option
Return Location:
Purpose of Trip:
Upload Itinerary

Upload a File
If Applicable Cancelof
Transportation Plans:
How will students be transported?
Funding Source:
If "Other" indicate here:
Number of Students:
How many days of school will be missed?
Number of Parent Chaperones:
Number of Staff Chaperones:
Cost Per Student:
Total Trip Cost :
Including this trip, what is the total number of trip request submitted by your organization this school year?
An E-mail will automatically be sent to Central Office and you will receive a confirmation E-mail once the "Submit" button is selected.
RELATED PROCEDURES:
09.36 AP.211, 0936 AP.212, 09.36 AP.23 REVIEW/REVISED:3/16/10
Should be Empty: