NWMSU permission form

NORTHWEST MISSOURI STATE UNIVERSITY CAMPUS VISIT

Wednesday, September 25, 2024
THE WHO, THE WHAT, THE WHEN AND THE WHERE.

TRIO Talent Search will be visiting Northwest Missouri State University on Tuesday, September 25, 2024. All high school TRIO Talent Search students, grades 9-12, are invited to attend.

HOW TO ATTEND: Student and parents/guardian need to complete and sign the Field Trip Form below. Incomplete applications will not be accepted. Limited space available. Trips are on a first come, first serve basis with priority going to 11th & 12th grade students. Once you turn in your permission form, you will receive a confirmation post card in the mail, if you do not receive this, that means we did not receive your permission form.

ABOUT TRIP: Free trip! Students participating in the trip will tour the campus, tour the dorms, learn about the admissions process and have lunch in an on-campus dining center. We will board the bus to leave campus at approximately 1:30 pm.

OTHER INFORMATION: School rules apply to this trip. Students should wear comfortable clothing, walking shoes and a coat or jacket. No short shorts or short skirts, baggy pants/jeans and/or tank tops will be allowed. Absolutely no foul or derogatory language will be allowed at any time. Students will not be allowed to smoke/vape. Failure to comply with any of these rules will result in dismissal from the trip and parents will be contacted to pick up the student from our location. Questions regarding this trip should be directed to your TS Advisor or the TS office. We look forward to your participation in this unique opportunity.
PLEASE COMPLETE THE FOLLOWING INFORMATION
STUDENT NAME*
SCHOOL*
GRADE*
ADDRESS*
CITY*
STATE*
ZIP*
STUDENT CELL*
PARENT/GUARDIAN NAME:*
PHONE NUMBERS: (Home)
(Cell Phone).*
(Work Phone)
EMERGENCY HEALTH CARE INFORMATION:
LIST ANY ALLERGIES
LIST ANY HEALTH ISSUES
DO YOU HAVE HEALTH INSURANCE?*

YesNo
IF so, NAME OF CARRIER
EMERGENCY CONTACT*
EMERGENCY CONTACT PHONE #*
ALTERNATE CONTACT*
ALTERNATE CONTACT PHONE #*
Please check the box by the location that pertains to you*

Murray pick up (School parking lot) Pick up 7:30 am, Return 3:30 pmCreston pick up (SWCC campus- Tech 1 bldg) Pick up 8:00 am, Return 3:00 pmLenox Pick up (school office entrance) Pick up 8:30 am, Return 2:30 pmBedford pick up (school main entrance) Pick up 9:00 am, Return 2:00 pm
Signature

Clear
PARENT'S SIGNATURE*

Clear
DATE*

MonthDayYear
Date
THIS FORM IS PENDING APPROVAL FROM YOUR SCHOOL OFFICIAL.
Agreeing: I hereby release all employees of SOUTHWESTERN COMMUNITY COLLEGE and the local school system of any liability connected with any personal injury, which may occur at the above mentioned event AND if my student isn't picked up at the designated time and location, they may be left unattended until I arrive.
WARNING: If you sign up to attend an TS event and do not show up and do not call to let us know, you will not be allowed to attend another campus visit or cultural trip for the current semester and the following semester. Please call if you cannot make it: 641-782-1392.
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NORTHWEST MISSOURI STATE UNIVERSITY CAMPUS VISIT

PLEASE COMPLETE THE FOLLOWING INFORMATION