IJOA-R/FIELD TRIP/EXCURSION APPROVAL FORM

Submitted by jhanscom on January 9, 2006 - 2:45pm

File: IJOA-R
Maine School Administrative District No. 11
Field Trip/Excursion Approval Form
Use this form for all field trips that take students off the regular school grounds, including walking trips. Field trips/excursions that leave the state or will involve an overnight stay require MSAD #11 Board notification. Please submit 3-4 weeks prior to the event. Other trips require 2 weeks prior notice. (Please print or type the information on the form or attach a separate sheet supplying all the necessary information.)
Type of Transportation: District Bus_____Walk_____Private Bus_____Private Car______
Approvals
Principal Date
Central Office Date
Transportation Date
Board Notification Date
(Required for overnight or out-of-state trips)
(must have copy of proper insurance and waiver claim form on file in Transportation Office)
Other

Departure Time: ________________ Return time in MSAD #11:______________

Number of passengers: ____________Students________________Adults

Please answer all of the following questions and complete the budget information at the bottom of this form. Your proposal must include all available information. Questions that don't apply to your trip should be marked NA.
1. General description of field trip. (Please include your itinerary.)
2. Statement of academic value. (Please be specific and explain how the trip relates to the curriculum.)
3. Rationale for trip selection, (Why was this destination selected? Is there a more local alternative? Are weekends a viable alternative to school days?)

4. What specific follow-up activities will be associated with the field trip?

5. How will this trip be evaluated by students, teachers, and chaperones?
6. How many substitutes will be needed for this trip to occur? For whom?
7 How many volunteer chaperones will assist with the trip?
8. To what degree will the trip be financed by district money?
9. Are all class members included? Yes No
Describe the process and criteria for participant selection, if there are limited openings.

10. What accommodation for food and lodging will be used for participants on this
trip?

11. Other

Clsrm/Bldg Budget* Transportation Budget* Other* Total Cost*
Substitutes
Mileage
Meals
Fees, etc.
Food
Lodging
Please estimate costs using maximum numbers.
Note: For overnight or out-of-state trips, it is strongly suggested that the staff advisor or other representative be present at the board meeting to elaborate on these and/or other questions the board may have.

Adopted 5/3/2007