Public Schools
Colchester T np
for A pproval of Field
Ap plication of a Field TriP
to request a
bY all staff
comp leted
s Form mu st be
OveNiew Thi The
Trips.
io#illl8iL'-'""
and nal
s Curricul um
Unit L rs*t ;t* (-)--
F ocu
n stru cti ona m2 Yes
ctlY related
to curncu
S rh IS TriP dire
Field nform atio n Method of T rans Po
rtati on
\ A 11 a- z Service Number
APPIi cant Name : Bus
School
A Number of Students 4
of D a v( S of T
rl p
Grade(s) & Group(s) N U m be
I oa
Date(s) of TriP
rn & N)
Event Phone Number
Destination +1,\ State
pme nt nequired
Destinati on Address Clothing / Equi
fro m Sch ool oo tJor,-r-,
Ti me of
Ime of Arriv al to School
S tu dent Cost lnformation Suggested Student Pocket
Money$ 16_
tost to Student $ aao
S u pe rvis ion nformation
1- Name
Cell Phone es3 -
Cell Phone
2. Name M perones students must be at least '1:5 for Grades K-2, 1:8 for Grades 3-5,
'l:1 0
List allAdult Cha Ratio of adult cha to
trips)
for Grades 6-8 and 'l :15 for Grades 9-12 (1 day trips) or 1:10 (overnight
-rBb
Adminis Si natures
Applicant Date
Department Chair (BA Only) Date Denred
Principal/Administrator Date Den ed
Assistant Supe te t Date Denied
Superinte Date Denied
Boa ofE o applicable
Board of Education Meeting Date \" \ CY \q a Approved Denied
Page '1
Updated Octob€r 2024
F e I d ,n p I
n Stru ct ion a
F el d Tri p Loca I P la n
tio n
Na me o f S taff cq^\
Co m Ple ti n
ra d e s Form
ro U p Afte n
d ng
, ns tru ction
a I Fo G u s of
spe cifi C C U rri Fi el d p
C u U m Sta
nda rd S Ad dre
,. s sed b
v F te d T p
t-\Shcrl ( t caT4)v\cI
"J -60 t; rAl* h^r^gs ra-l pl.z
11 $ft>za,n
ASSeS sment
of Stud ent Leaming
b -D{scts<ro"r._, s rJ{^_
t
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L1.*
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or\y\ pcc$lna-.,
'aba<)urr 0 +-\n{rr,.,-.."r arAA<.(Sn"_Lr\,+
k"a^.ga_1fu.
Tri p Age n dalActi vt ties
L I S UA tta ch n ti re b re a k o U t o f t me S fo r a
ch d a v. I n U d e tra e I t m a n d a I a cti viti S
Date/Time Location
Activity
,+
(Y1
I r-) \)
U A &m L nt/:-
(^J
6 \owt \r y1-
Lrn +
4:oo -B+ €-el^,r7'ro1ar'1 arrri ra-/-
I
Bus lnformation
Bus Reservation Date Price of Bus(es) $
Page 2 Updaled October 2024