School Committee Proposal for Overnight/Out of State Field Trip If you are planning any overnight or out of state trip, please complete this form. You The following information is needed to present to the School Committee for approval at least 2 months prior to departure. In order to complete this form, you will need the following information: Approximate per student cost of field trip Predicted Trip itinerary outlined in a Google Doc or other document Any outside Vendor contact information (if you are using one) If you have any questions, please contact Jeannette Sheahan (
[email protected]). Your email address (
[email protected]) will be recorded when you submit this form. Not tsmolka? Sign out * Required
1. Trip Leader #1 First Name *
2. Trip Leader #1 Last Name *
3. Lead Teacher's Cell Phone Number *
4. Lead Teacher's Department * Mark only one oval. Administration English Fine Arts / Applied Tech Guidance Health and Fitness Learning Commons Mathematics METCO Nurse Performing Arts Science Social Studies Special Education World Language Athletic Overnight Trip Club or cocurricular activity Other 5. Trip Leader #2 First Name
6. Trip Leader #2 Last Name
7. Trip Leader #3 First Name
8. Trip Leader #3 Last Name
9. Other collaborators
10. Trip name *
11. Trip Destination(s) *
12. Brief Description / Summary of Trip * 13. Estimated Departure Date of Trip * Example: December 15, 2012 14. Estimated Return Date of Trip * Example: December 15, 2012
15. Estimated number of students who will participate * Mark only one oval. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 16. Estimated per student cost of trip *
17. What grade levels can participate in the trip? * Check all that apply Check all that apply. Grade 9 (YOG 2021) Grade 10 (YOG 2020) Grade 11 (YOG 2019) Grade 12 (YOG 2018) 18. Number adults on trip * Mark only one oval. 1 2 3 4 5 6 7 8 9 10 19. Number of nights you will be away * Mark only one oval. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Other
20. Number of School Days Missed * Mark only one oval. 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Other 21. Please upload your predicted itinerary and any additional files. * Files submitted: 22. Are you working with an outside vendor (Travel Agent, Tour Group, etc)? * Mark only one oval. Yes No
Skip to question 23. Skip to question 28.
Vendor Contact Information 23. Company Name *
24. Contact Person *
25. Phone Number *
26. Email *
27. What type of services will the vendor provide? (Transportation to destination, transportation while at destination, reservations for overnight stay, meal planning, site visits and reservations, etc.)
Field Trip Curricular TieIn This sections addresses how the Field Trip ties in with your curriculum content, helps build group identity, celebrates the culmination of group work, or enhances extracurricular activities. You may attach files that address this topic in the first question, or complete the following three questions with this information. 28. Please attach file(s) supporting the educational purpose of your Field Trip. Files submitted:
If you did not attach file(s) in the previous question, please answer the next three questions. 29. Is the field trip directly related to a unit of study or a schoolsponsored program or activity in which students are involved? Please explain. 30. Is the field trip used to build group identity and/or culminate or celebrate group work? Please explain.
31. Is the purpose of the field trip to enhance extracurricular activities? Please explain.
Miscellaneous Information 32. Any other comments?
After you submit this form, it will be routed to your Department Chair, the Principal, and the Main Office for submission to the School Committee. A copy of your responses will be emailed to
[email protected]
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