Field Trip Request Form 2340A(Over $500)

Field Trip Request Form 2340A

(Over $500)

Request Approval for a Field Trip (Out of State, Overnight or Staff Sponsored)

For trips not during school hours and less than $500.00 please complete Form 2340A-1

IMPORTANT:

Trip sponsors may NOT solicit the trip to families or students prior to approval, nor have anticipated chaperones apply for background checks prior to trip approval. If trip is approved, you will receive an email regarding requirements and next steps.

Field Trip Type:*

Select or enter value

School:*

Select or enter value

Teacher(s)/Trip Sponsor(s):*

Class(es):*

Project Topic: *

Please indicate the field of study. (i.e., Culture & Politics; Health, etc.)

Curricular/Connection: *

Please indicate the subject/class matter that will be explored.

Describe the educational objective(s):*

How does the experience enrich the curriculum?

Destination:*

Start Date of Field Trip:*

End Date of Field Trip*

Depart from School:*

Depart from Destination:*

Return Time to School:*

File Upload*

Please attach detailed information about the study trip that you anticipate using (solicitation information, trip budget, connections to standards/curriculum, details on which students can participate).

Drag and drop files here or

Anticipated Number of Students:*

Total Number of Adults:*

Minimum of two staff member chaperones required for overnight field trips.

Number of Classified Staff:*

Required that there be at least one professional staff member for each 30 students.

Number of Certified Staff:*

Required that there be at least one professional staff member for each 30 students.

Number of Parents/Guardians/Chaperones:*

Background checks must be completed and verified for ALL non-staff adults attending per MSDWT approved POLICY 8120 (Volunteers). Staff sponsor is responsible for verifying the required background checks have been completed and verified prior to the field trip.

Number of MSDWT Buses Requested:*

Each bus MUST have at least one certified staff member on board.

0

1

2

3

4

5

6

7

8

9 or more

Number of MSDWT Accessible (Wheelchair) Buses:*

MSDWT Approved Charter/Contracted Bus:*

If using this option, please indicate name of bus line.

Parent permission forms will be in the teacher’s possession during the field trip:*

(Including emergency medical authorization and special medical instructions for all students)

Select or enter value

Student Trip Expense:*

(per person)

Anticipated student incidental expenses not included in the trip expense:*

(per person)

What consideration/arrangements are in place for students unable to pay:*

Please indicate available sources of funding to assist students in attending - i.e., fundraising, scholarships, etc.

Principal Approval Signature*

Building Principal has approved this trip and the document related to this trip with their signature has been uploaded to the Request form in the above upload area. You will need to have your FortiToken to access the PDF.

ALL HANDBOOK AND STUDENT RULES APPLY (Policies 8640 and 2340)

Please check the box below to send yourself a copy of your request before submitting.

Send me a copy of my responses

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