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Colchester Public Schools
Application for Approval of Field Trip
Overview: This form must be completed by all staff to request approval of a field trip.
Directions:
1. Complete the form attaching all applicable documentation and submit to your administrator. The application
must be submitted at least two weeks prior for in-state field trips, and two weeks and two months prior for
out-of-state trips.
2. The Administrator will recommend or not recommend. If approved, the form must be sent to the
Superintendent.
3. The Superintendent will either recommend or not recommend and will bring to the Board of Education if the
request is for an out-of-state field trip.
4. If applicable, the Board of Education reviews and makes the final decision.
Today’s Date: 3/15
Field Trip Information
Applicant Name: Marinne Cheney Method of Transportation: Coach Bus
School: Gkease-SeRsot & A Bus Service Number(s) (if applicable):
Grade(s) and Group(s): chamber and Women's Choirs Number of Students: 48
Date(s) of Trip: May 18 2022 Number of Day(s) of Trip: {
Event: Travel to Broadway to see Wicked
Destination: G Phone Number:
ershwin Theater Teacher cell below
fee See 222 W 51 st ST oe NY
Time of Departure From School:6:30 AM Special Clothing and/or Equipment Required:
Time of Arrival Back at School: 10:00 PM None
Student Cost Information
*Cost to Student: $ 210.00 Suggested Student Pocket Money: $ 20.00
Su pervision Information (List names of all employees, other chaperones, and cell phone number for each)
1. Name: Marinne Cheney Cell Phone:
2. Name: Cell Phone:
List all adult chaperones: Ratio of adult chaperones to students must be at least: 1:5 for Grades K-2, 1:8 for Grades 3-5; 1:10 for
Grades 6-8; and 1:15 for Grades 9-12 (one-day trips) or 1:10 (overnight trips)
TBD: Jen Kollwitz and Ashley Zaugg
PChM Mee Clee ery
Applicant Signature
pp asia ERecormnrended Not Recommended
Superintendent’s Signature, {Recommended Not Recommended
Board of Education (i :ppiicabie)
Board of Education Meeting Date:
Not Recommended
Bus Information
Bus Reservation Date:
Price of Bus(es): $
*If a trip toa foreign country, please complete and attached the CIRMA insurance application and notify parents of coverage Last Updated 5/27/21
ip
Field Trip Instructional Plan
Colchester Public Schools
Field Trip Location(s): See Attached Plan
Reference Check: Visited site on: or Spoke with:
Name: Grade/Group:
(Teacher(s) completing this form)
Instructional Focus of Trip
e This field trip is directly related to curriculum Yes No
e Curriculum Unit(s):
e Specific Curriculum Standards Addressed by Field Trip (please refer to CT Core and disciplinary standards):
e Assessment of Student Learning (describe or attach the work students will complete upon their return to
convey the learning):
Trip Agenda/Activities: List/attach entire break out of times for each day. Include travel time and all activities.
Attach additional sheet if needed.
DATE/TIME LOCATION ACTIVITY
« JY
Approvals: iA 8 [tt la e | fApproved Denied
Department Chair (High School Only) Date
ie
ae Tofu [ Axoproved Denied
Principal Date
(4 4 ma "Approved Deni
Z enied
Director of Teadhing ahd Learning Date | ke re LI
Undated 5.27.21
Field Trip Cost Form
Date(s) of Trip:
Event: Travel to Broadway to see Wicked
M&J Bus(es) ONLY
Number of Students: Estimated Hours for trip:
(Add 1 hour pre/post trip)
Number of Buses:
Per Student Calculations:
M&J Bus(es) ONLY Coach Bus(es) ONLY
Admission per student:
Miscellaneous Fees per student:
Total admission and miscellaneous fees:
Cost of Bus
Total Field Trip *Cost per Student:
Additional Costs:
Number of Substitute Teachers 1
Rate per Day
Special Education costs
Cost Associated if Nursing Required
Tota! *Cost to District: 0
Total *Cost of Trip: 0
Alternate funding for trip provided by: Choir Activity Account and fundraisers.
*Insert these costs on the accompanying Field Trip Application F dated 5.27.21
orm updater Lf.
Field Trip Instructional Plan
Field Trip Location: Wicked on Broadway, NYC
Reference Check: N/A
Name: Marinne Cheney Grade/Group: Chamber and Women’s Choirs
# of students: 40-48 Cost to student: $210.00 (All students can
attend regardless of ability to pay because fundraisers have happened in the past and
will continue to happen this year.)
Curriculum Unit: Listening and Responding to a live performance.
Specific Curriculum Standards Addressed by Field Trip:
According to the National Music Standards:
-Under the Performing Category
~ Analyze the structure and context of varied musical works and their
implications for performance.
- Under the Responding Category
~ Analyze how the structure and context of varied musical works inform the
response.
- Interpret: Support an interpretation of a musical work that reflects the
creators’/performers’ expressive intent.
- Evaiuate: Support personal evaluation of musical works and
performance(s) based on analysis, interpretation, and established criteria.
Assessment of Student Learning:
-Students will listen to excerpts of the music prior to watching the show in order to begin
analyzing the implications for performance.
-Students will study, analyze, and sing a piece from this show in the Pop’s Concert in
June.
-After seeing the show we will have an informal discussion about the music including
how the context around the creation of the pieces informed their response to the
performances of the pieces. How the performers’ interpretation, stage presence,
dynamic contrast, musicality, and acting all contributed to the musical intent. Whether
the musical choices were appropriate for this context.
COVID Safety Measures
-Wear a mask while inside the venues.
Trip Agenda: Wednesday, May 18
6:30 AM
10:00 am
11:30 am
1:00 pm
2:00 pm
5:00 pm
10:00 pm
Depart Bacon Academy
Approximate arrival in Times Square
Lunch at Bubba Gumps or similar (included)
Group will walk over to the theatre
“TBA” Show time for Wicked
Depart theatre for Bacon Academy with a dinner stop enroute
Approximate arrival at Bacon Academy