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Central Office Due Dates: (}
In state: TWO (2) weeks prior to trip Application for Approval of a Field Trip
Out of state and/or overnight: Colchester Public Schools
TWO (2) weeks and TWO (2) months prior to Board meeting for BOE approval
schoot Paco Academy _
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CATO SD
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Date of application: _; la j
Dais(s) of tip: Wed, May b. 2020
3, A } e
% co “Hof Day(s) of Trip: |
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Bus Service Number(s) (if applicable}: K} LH € | -ximber of Students: > 2.
Baring the field trip: 860.537.2326 and cell phone 860.790.1412
Event: Vida Amer Rang \ Mexican urali sks Remake. Amoritan Ark
bimmey Mvsewih ‘p Phone Number: 2\2-57 30D
adsress: FA_hanvevoort St NY NY \ poi
Te? “aWAve Newbre yy igo) sate_ VY
Time of departure from school: S ‘ | Saag ime arrival back to school: / t 30 PM
Special clothing and/or equipment required:
*Destination:
Supervision provided by: (List names of all employees, other chaperones, and cell phone # for each)
Main contact(s) and cell phone number(s) (list one or two people):
1. Name: DCO N J ahnsten Cell Phone: l Sh i y O
2name_deoniter Ko wit. cat Phone. Ko OF UpSb
List all adult chaperones: Ratio of adult chaperones to students must be at least: (grades K-2 1:5) (qradas 3-5 1:A\ lor ft 0) (grades. 9s,
10 PeHOY ahs.) _
he Jenniker Kal\witz. __
eather TBD
Teacher _ TBD
Total Cost of Trip*: $ Cost to District:$ Cost to Student:$ 7 Suggested Student Pocket Money:$ ‘x }
*Attach completed Field Trip Calculator form.
4
If there is a cost to the students and they cannot afford the cost, indicate the source of scholarship funds:
huduny Achy ity Fund
Applicant’s Signature | RAALIM NAW NICS Dept. Chair Signature
Principal's.Signature_ A _ Date: Leslee [Re rimended [[] Not Recommenfféd
eS (Dye
Superintendent's Signature it Date: | A / Recommended [_] Not Recommended
ani _ 7 /
~~~cilf-applicable: Board of Education eeting Date []Recommended [_] Not Recommended
Must be approved by Board 2 months prior to out of stale and overnight trips
Bus Reservation Date: Price of Bus(es):
“If a trip to a foreign country, please complete and attached the CIRMA insurance application and notify parents of coverage O7NBN8
2018-2019 Field Trip
Cost of Trip 6153 Regulation
Appendix €
Dae ofine: TANednesd ay, May ©, 2020
Event |\}iGO Dorey coma: Mexican Mya sts Leia
Number of Students:
M&J Bus(es) ONLY
Estimated Hours for trip:
(Add 1 hour pre/post trip)
Amar ca)
Apr
Number of Buses:
Per Student Calculations:
M&J Bus(es) ONLY
Admission per student: re
P 50
Miscellaneous Fees per student: | [ea
Total admission and miscellaneous fees:
Cost of Bus
Total Field Trip *Cost per Student:
Additional Costs:
Number of Substitute Teachers ? {\ wey ot sul
{ig pill 4° fe
SSewe Witnben o
| /Fy re
Rate per Day
Special Education costs
Cost Associated if Nursing Required
Total *Cost to District:
Total *Cost of Trip:
Alternate funding for trip provided by: StUAUAr GUM) ty hind
*Insert these costs on the accompanying Field Trip Application
Form revised on 7/2018