EXTENDED FIELD TRIP REQUEST FORM A (Policy 607.06)

EXTENDED FIELD TRIP REQUEST FORM A (Policy 607.06)

This form must be completed and submitted at least 60 calendar days in advance of the trip and before the trip can be offered to students. Form B must be completed for final approval of the travel. When students who will be going on the extended field trip are known at the time of initial application, both forms may be completed and submitted for approval simultaneously. Only Elkhorn students and their sponsors may participate. The completed form(s) must be submitted to the Principal.

1. Provide a brief description of the trip, including how it relates to the curriculum and ways in which curriculum benefits will be documented:

 

2. Who will be participating (e.g. team members, club members, etc.)?

 

3. Anticipated number of student participants:

 

4. Sponsors:

Names | Address |  Phone Numbers

1)

2)

3)

5. Describe any costs or financial benefit to sponsors:

 

6. Cost per student: (Provide breakdown costs for transportation, lodging, registration, etc.)

 

7. Are students responsible for all costs? If not, how is the trip being funded?

 

8. If the student is responsible for costs, what provisions have been made for students who cannot afford to participate?

 

9. Tour or travel agency, if applicable (attach a copy of the contract):

Name:
Address:
Phone:

10. List references for this tour or travel agency, if applicable:

 

11. Itinerary: Include dates, times, cities, countries, hotels, residences and form of transportation for each day from the time of departure from Elkhorn to return.

Date |  Time | Destination | Lodging | Transportation

 

12. Insurance underwriter for tour or travel agency (if applicable):

 

13. Name of airline (if applicable):

 

14. Name of person completing this form:

Preliminary Approval of Form A: The signatures below are required prior to offering the travel opportunity to students and parents. For final approval, Form B must be completed.

 

___________________________________
Activities Director

___________________________________
Date

___________________________________
Building Principal

___________________________________
Date