Policies » Section I: Instruction » IJOA-R: Request for Educational Field Trip Form

Policy Date: 03/07/2024

CSD File: IJOA-R
REQUEST FOR EDUCATIONAL FIELD TRIP

At least four weeks before the proposed day of any field trip the teacher(s) shall supply the following information to the Principal in duplicate.

Grade: ___________            School:  __Henry W. Moore School____            Date :____________

Trip ___________________________________________________________
___________________________________________________________

Date of Trip __________ Estimated Miles _________________
Departure Time ____________ Return by ________________
Number of Pupils ______________ Adults ________________
Teacher(s) __________________________________________________
Number of Buses ____________________________
Number of Chaperones ________________________
Cost to Student: _____________________________

Educational Objectives and Specific Ties to the Curriculum:
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

Approved: ______________________________ Date: ______________ 
                      Principal

Approved: ______________________________ Date: ______________
                      Superintendent

⬜Does Require School Board Approval*          Date: ______________
⬜Does Not Require School Board Approval

See Policy IJOA* – “Any overnight or out-of-state field trips”
Sleeping quarters will be shared by those of the same sex.
Adopted: May 7, 2009
Reviewed: January 3, 2019
Revised: November 2, 2023, March 7, 2024