NDCL Field Trip Planning Form

Please complete the following form as fully as possible. After he reviews your request, Mr. Waler will notify you by email if your proposed field trip is approved.

* Today's date:

* Name of person submitting this form:

* Email address of person submitting this form:

* Name of class or group participating:

* Number of students participating:

* Activities in which students will be engaged:

* Date of trip:

* Destination of trip:

* Actual address of destination:

* NDCL vehicle(s) requested:

None needed

Bus

Van

Total number of passengers, including chaperones:

Time group intends to leave NDCL:

Time students need to arrive at destination:

Departure time from destination:

Name(s) of chaperones who will ride with students:

Special instructions, if any, for Mr. Bozeglav as he arranges transportation:

Regarding lunch, participants will:

eat lunch at school.

eat lunch at this location:

* Regarding attire, participants will:

wear the regular uniform.

wear the dress uniform.

wear dress-down clothing.

* Rationale for this decision:

Please list the name and substitution needs of each chaperone separately.

Faculty chaperone #1:

Faculty chaperone #2:

Faculty chaperone #3:

Special instructions, if any, for Mr. Bonacci as he arranges substitutions:

Cost per student (admission fees, ticket costs, etc.):

If applicable, check should be written for this TOTAL amount:

If applicable, the Finance Office should make check payable to:

If applicable, the Finance Office should:

give the check to the person organizing the trip.

mail the check. (Give complete address in special instructions below.)

Special instructions, if any, for the Finance Office:

* Indicates Response Required