Extended Field Trip Request Form: IJOA-E2

Please complete the following and submit to the building administrator responsible for field trip approval.

1. School: Brighton Heritage
2. Organization, class, club requesting the trip:
3. Destination:
4. Date(s):
5. Time out of school:
6. Approximate distance to be traveled round trip:
7. Number of students: involved:
8. Number of chaperones:
9. Method of transportation:
10. Manner in which the trip is to be financed:
    • a)
    • b)
    • c)
    • d)
    • e)
11. Estimated total trip cost: $
12. Estimated cost to each student: $
13. What accommodations are to be used?
14. Explain the purpose of the trip including educational objectives, value to students, etc.
15. Are there alternatives to this trip? available: Yes Explain:
16. What commitments to parents or students have been made to date?
17. Does this trip involve a state or national activity? Yes Explain:
18. Has this organization, class, club, participated in this or a similar activity in the past three years? Yes If so, please list and describe:
19. Sponsor comments:

Sponsor Signature_________________________

Date_________________________

Building administrator comments:

Administrator’s Signature_____________________

Date____________________

Central administrator comments:

Superintendent’s Signature________________________

Date________________________