MSDLT K-12 FIELD TRIP REQUEST FORM

APPROVAL PROCESS: 1. Request reviewed/approved by building/principal. 2. Request reviewed/approved by Assistant Superintendent/LECC. 3. Request reviewed/approved by LT Board (if applicable). 4. Sponsor will receive email confirmation when approval process is complete. Note: When completing the form, it is recommended that you do not utilize the 'auto-fill' option on your device, as this often leads to submission errors. Please send any field trip request form questions to Miranda Fransen (mirandafransen@msdlt.k12.in.us).

PLEASE REVIEW this IMPORTANT information and additional guidelines!

  • For Secondary Teachers: Field Trip should should be discussed with your Department Chair/Leader PRIOR TO submitting this form.


  • If you are taking different groups to the same destination but on multiple days/dates, you must submit a SEPARATE FIELD TRIP REQUEST FOR EACH. (SPED exceptions are outlined below.)


  • School day trips making use of MSDLT yellow buses cannot depart before 9:00am and must return NO LATER THAN 1:45pm.


  • TIER 1 & 2 Field Trip (Indiana) Requests must be submitted a MINIMUM of 2-WEEKS prior to the date of the proposed trip.


  • TIER 3 requests for MULTI-day, in-state or out-of-state (within U.S.) must be submitted AT LEAST 2 MONTHS in advance, & International travel requires MINIMUM OF 5 MONTHS in advance of trip. These requests must include an itinerary to be submitted to the Board for review.


Student Safety and Well Being Guidance


  1. ALL Field Trips: Print a copy of the Medical Emergency Information    Form found in the Custom Form tab in Skyward. These forms will be kept by the leader of the field trip. If the form is not completed for this year, teachers will need to make sure their classroom forms are up to date.
  2. ALL Field Trips: Meet with your school nurse at least two weeks before the trip to arrange for care of students with medication needs, chronic health issues or daily treatments that will need to be completed on the trip. School staff training may be needed to take care of student medical needs.
  3. If this trip is outside school hours or overnight, parents must fill out the MSDLT Oustside School Day Field Trip Request to Administer Medication form for any medication not given during the school day.


Outside of the School Day Field Trip Request to Administer Medicine -English

Outside of the School Day Field Trip Request to Administer Medicine-Spanish

MSDLT Yellow Bus Blockout Dates:

If you plan to utilized MSDLT buses, please be aware that NO MSDLT FULL-SIZE BUSES will be available during the school day on the following dates:


•    July 29, 2025- (Drivers ASM/Route Bid)

•    July 30, 2025- (Transportation Staff Back to School Meeting)

•    August 27, 2025- (Safety Meeting)

•    September 23, 2025- (Job Spark)

•    September 24, 2025- (Job Spark)

•    September 25, 2025- (Parent-Teacher Conference)

•    December date TBA- (Readers are Leaders)

•    February 25, 2026- (Safety Meeting)

•    April 29, 2026- (Safety Meeting)

•    May 26, 2026- May 27, 2026- (Last Week of School)


CUT OFF FOR TRIPS FOR 2025-26 May 11, 2026

What school year will this field trip take place?*
What type of Field Trip are you planning? READ DESCRIPTIONS PROVIDED BELOW and select the appropriate trip TIER.*
  • TIER 1 (T-1): Trip lasting less than 10-hours and requiring travel inside Marion county or immediately surrounding counties ONLY. (Boone, Hamilton, Hancock, Hendricks, Johnson, Morgan, Shelby)
  • TIER 2 (T-2): Trip lasting longer than 10-hours and/or requiring travel beyond Marion county and immediately surrounding counties. (Boone, Hamilton, Hancock, Hendricks, Johnson, Morgan, Shelby).
  • TIER 3 (T-3): Trip that is for MULTIPLE DAYS and/or OUT-OF-STATE or outside the U.S. Remember to submit an itinery for Tier 3 trips.
  • REMINDER: For school day field trips, full-size MSDLT buses cannot depart before 9:00 am and must return to the school no later than 1:45pm!
  • MSDLT full-size bus=50 person max capacity (+ driver)
  • MSDLT activity bus=14 ct. max capacity (including driver) (Utilization of Activity bus is arranged by the sponsor/school.)
  • Charter buses are arranged/scheduled by the sponsor/school.
  • If "Other" is selected, provide additional explanation below.
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. If utilizing MSDLT full-size bus(es), indicate below the # needed. (Note: 50-person maximum seating/per full-size bus. ) If none, indicate '0.'


Activity buses must be reserved through the school and certified driver must be provided. 14-person max seating/per activity* bus (including driver)

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  • Field trips should be self-funded.
  • Sponsors are required to indicate the estimated cost of transportation as well as who is to be invoiced.
  • BEFORE completing/submitting your trip request, use the information provided below to calculate your transportation cost AND share this information with the department/individual that will be responsible for payment.
  • Cost of transportation calculations:
  •  MSDLT bus = $3.00/per mile + $22/hr/driver (2-hr. min.) Total Miles (Distance from transportation to school/pick-up point to destination + return from destination to drop-off point/school to transprotation.) X $3.00 = _______ + Driver Hours (total trip time =1 hr for driver's time to and from transportation) X $22) = _____ X # of buses (50/per bus). ). Hourly driver cost applies for the duration of the field trip except for some tier 3 trips.
  • Continue with completion and submission of Field Trip Request ONLY AFTER YOU HAVE CONFIRMED SOURCE OF FUNDING. USING THE COST INFORMATION PROVIDED ABOVE, estimate the total cost of transportation and enter in the space below.
  • For Lifeskills/SpED CBI trips and trips utilizing an Activity Bus or Charter, indicate N/A.
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Dept. Leader Approval*

Has the proposed trip been shared with and approved by your Department Leader? (MS and HS only, ELC/Elementary indicate N/A)

Is this a multi-day trip?*
Is there an overnight stay?*

If there is overnight(s) stay, indicate "yes." If not multi-day, indicate "N/A."

Is this an out-of-state (leaving Indiana) trip?*
Is this an international (leaving U.S.) trip?*

Multiple grade levels can be selected.

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First and Last Name

Cell phone # preferred (with area code) or school direct line.

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Include street, city, and zip.

If visiting a 2nd destination, replace N/A with: site name, street, and zip of second destination here.

If visiting a 3rd destination, replace N/A with: site name, street, and zip of second destination here.

A brief description of trip focus and/or curriculum standards met.

Is this a recurring trip?*

NOTE: "Yes" applies to SPED CBI and Community Service programs ONLY. All OTHERS need to submit a separate form for each day/date. If "yes," enter date of 1st occurrence in "Date of Field Trip" and upload spreadsheet or listing of dates through Document Upload (below). Only ONE completed form with attached/uploaded details will be required.

If "yes," indicate # of wheel chairs in "Special Accommodations" response (below).

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Indicate any special seating requirements (E.g. #wheel chairs, star seat belts) If none, indicate "none."

Indicate building pick-up point. (E.g. main entrance, or Door #3)

In 30-min. increments, indicate the estimated duration/total # of hours for requested trip. (E.g. 5, 7, 8.5)

Departure/Return Times:

Be sure to indicate AM or PM for any/all departure/return times.

Trips using MSDLT buses for transport may not depart before 9:00 am.

What time will you board the bus for your return from the site of your visit. Note: If utilizing MSDLT full-size bus, you MUST be back at your building no later than 1:45PM.

If your trip includes a 2nd stop/destination...What time will students re-board the bus to depart 2nd destination?

If your trip includes a 3rd stop/destination...What time will students re-board the bus?

Trips using full-size MSDLT buses for transport on school days MUST return NO LATER THAN 1:45 pm! What is your estimated time of return?

Chaperones:

Recommended ratio for elementary = 10:1 Minimum of 1 staff member/per bus for secondary Note: Non-Staff Chaperones must have a completed limited background check on file at the school.

This would include the # of parents, grandparents, and other volunteer chaperones that are not employed by MSDLT. (LT Volunteer Background Check required.)

This would include teachers, IAs, administrators... employed by MSDLT.

Parent Permission forms should be collected for ALL field trips.

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Cost of Trip / Funding:

Field trips should be self-funded. When planning the trip budget, be sure to include/consider:

  • As calculated and entered above.
  • Substitute Teacher cost (if required) $116.55/day
  • Site Admission costs

Is this trip for the purpose of competing in a performing arts or athletic competition?*

Select the group or team that will compete.

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Please provide the name of the individual who has approved the funding of this trip and should receive the invoice. Note: For Lifeskills/SpED CBI and trips utilizing an Activity Bus or Charter, indicate N/A. (First Last)

SpED CBI indicate N/A.

Estimated cost to student participants.

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

Sub Needed?*

For how many days will you require a substitute teacher for this field trip? REMEMBER: If a sub is needed, you must submit your request through Kelly Services.

For out-of-state and/or multi-day trips, additional information as requested below is REQUIRED. Field Trip Request may be denied if necessary information is omitted. (Supporting documents can be uploaded below.) Note: At a minimum, a general itinerary should be uploaded with submission of the trip request. If any of the other required items/documentation is not yet available, be sure to indicate the date by which it WILL be available.

Required for Tier 3 trips.

Drag and drop files here or
Detailed ed. overview...*

...(including standards being addressed, if appropriate) and a time line is attached and is on file at the school. (Note: If the answer is "NO," you must respond to 1-A.)

2) Complete itinerary...*

...for duration of trip (including hotels w/ phone #'s and addresses) is attached. Itinerary should include means of transportation & information regarding commercial transportation company utilized. (Note: If the answer is "NO," you must respond to 2-A.)

3) Manifest...*

...has been completed that includes names of all persons traveling with the group with their phone #'s, address, and emergency contact person (w/ phone #, address). Copy of manifest is attached, on file at the school, and in possession of trip leader. (Note: If the answer is "NO," you must respond to 3-A. Manifest is NOT required for SINGLE day, out-of-state trip requests - select "N/A.")

4) List of chaperones...*

...their addresses, phone #'s, and relationship to school is attached and on file at the school. It is important that when group includes male & female students that the chaperones reflect a similar percentage as the students. (Note: If the answer is "NO," you must respond to 4-A.)

5) List of accountability rules...*

...for students traveling has been distributed to the students and their parents, and is attached. (Note: If the answer is "NO," then you must respond to 5-A.)

6) List of rooming assignments...*

...and chaperones assigned to those rooms is attached and on file at the school. (Note: If the answer is "NO," you must respond to 6-A. Rooming info. is NOT required for SINGLE day, out-of-state trip requests - select "N/A.")

NOTE: If you wish to receive an e-mail confirmation and copy of your request, please check "send me a copy of my responses" at the bottom of the form BEFORE you submit.

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