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Request for Field Trip

Mary Walker School District No. 207

Springdale, Washington 99173

School Bus

Request for Field Trip

Requirements:

This request must be submitted at least two (2) weeks prior to the trip.

A list of ALL potential students attending must be attached. This list will be given to the school nurse and the attendance officer.

ALL field trips must be approved by the administration.

ALL Student Permission Slips must be turned in to the teacher/advisor prior to the trip.

Today's Date*

Answer required for "Today's Date"

Person(s) submitting request:*

Answer required for "Person(s) submitting request:"

Destination Address:*

Answer required for "Destination Address:"

City*

Answer required for "City"

What Group(s):*

Answer required for "What Group(s):"

# of Students:*

Answer required for "# of Students:"

# of Chaperones:*

Answer required for "# of Chaperones:"

Date of Trip:*

Answer required for "Date of Trip:"

School Departure Time:*

Answer required for "School Departure Time:"

Destination Arrival Time:

Answer required for "Destination Arrival Time:"

Destination Departure Time:

Answer required for "Destination Departure Time:"

Return to School Time:*

Answer required for "Return to School Time:"

District Paid Field Trip?*

Answer required for "District Paid Field Trip?"

Yes

Is this a competition?*

Answer required for "Is this a competition?"

Yes

Is there a cost per student?*

Answer required for "Is there a cost per student?"

Yes

Approx total cost:

Answer required for "Approx total cost:"

Names of Chaperones: *

Answer required for "Names of Chaperones: "

List of Students:*

Answer required for "List of Students:"