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2
COLCHESTER
PUBLIC SCHOOLS
~~
Overview : This
Application for Approval of Field Trip
Evct4 I~
ACy XGA
Colchester Public Schools p “y mn 225
Form must be completed by all staff to request approval of a Field Trip
3. If approved by the Assistant Superintendent, th
1. Complete the form with all applicable documenta pal
The Form must be submitted at least 2 weeks prjor fo the Field Trip for In-State Trips and 40 weeks prior to the Field Trip for Out-of-State Trips.
2. If approved by your Administrator, the form must be sent to the Assistant Superintendent for approval.
16 form will be sent to the Superintendent for approval.
4. If the Trip is Out-of-State, it will be brought to the Board of Education at their next scheduled Meeting for approval and final decision.
nN and submit to yc ly) and your Administrator.
onl
Curriculum Unit :
@)
Applicant Name : Cindy tra {
SNE __|Method of Transportation: School Van / Bus
Baean ‘Acad
School : PINS) Bus Service Number :
Grade(s) & Group(s) "ROhohcs | G- (a. [Number of Students: 22
Date(s) of Trip : M arch 2!) -23 Number of Day(s) of Trip: ~ a
Event: WPI District Compehhb
Destination: WP! Harrington Anditorium|Phone Number ; Bes. 53]. Sc00
Destination Address : 100 in&h tute Rd, werchal
tate: AAA-
Time of Departure from School :
Clothing / Equipment Required :
Time of Arrival to School
Team Shirt [Robot /Tool 8
Suggested Student Pocket Money $
1.Name: 10M Fraisner CetPhone: = 759. 444. (6 OS™
2.Name: AlQn Moacksfieid Cell Phone : S60. G4g 2992
List all Adult Chaperones: Ratio of adult
1:10 for Grades 6-8 and 1:15 for Grades
Cindy Praisner
Other Mmerytors as ¢
haperones to students must be at least : 1:5 for Grades K-2, 1:8 for Grades 3-5,
9-12 (1 day trips) or 1:10 (overnight trips)
560.705.9176”
available
applicant (i ndip Aad tr] pate 2/4/3967
Department Chair (BA rar, 2 ¢ Date Approved Denied
Principal/Administrator yy Cie Date Approved Denied
Assistant Superintend nt 7 “ Date : Approved Denied.
Superintendent Date J J) [LS Approvdi Denied
Board of
cation Meeting Date
Approved Denied
Page 1 Updated October 2024
Field Trip Location: WP] Hayy
LNgtON Auditors um
Reference Check: Visited Site On!:
Name of Staff Completing Form :
OR __ Spoke with: F7RST Ayan
[rOISNEec ¥
indy |
Grade / Group Attendi G-1iD
Rbbothcs Team,
N/A
Specific Curriculum Standards Addressed by Field Trip:
Assessment of Student Learning:
N i/A
List/Attach entire break out of time
S for each day. Include travel time and ail activities
Date/Time Location
Activity
See Attaiched
Bus Reservation Date
Price of Bus(es) $
Page 2
Updated October 2024
M&J BUS INC. . Evert 4 an
TRANSPORTATION REQUEST FORM
PLEASE USE THIS FORM TO REQUEST BUS TRANSPORTATION. ALL ORDERS BEING PAID BY COLCHESTER PUBLIC
SCHOOLS MUST BE ACCOMPANIED BY A PURCHASE ORDER. CALL FOR A PRICE QUOTE. FILL IN THE FORM
BELOW AND FAX IT TO OUR OFFICE AT 860-537-2625. PLEASE SIGN THE FORM AS YOUR APPROVAL TO BOOK
THE TRIP AT THE QUOTED PRICE. WE WILL THEN BOOK THE BUS AND RETURN A SIGNED COPY BY AN M&J
EMPLOYEE TO LET YOU KNOW WE RECEIVED THE ORDER. PRICES ARE SUBJECT TO CHANGE IF THE TIMES OR
DESTINATION OF THE TRIP IS CHANGED IN ANY WAY.
BILLING TIME IS 4 HR BEFORE DEPARTURE TIME AND CONTINUES THROUGH % HR AFTER RETURNING TO
‘DEPARTURE POINT.
TODAYS DATE: OA / oe) | 25
PERSON PLACING ORDER: _ SWS ee Ue hi a Noe
SCHOOL OR ORGANIZATION: BA
PHONE NUMBR: (8) 531- AZ18
NUMBER OF BUSES REQUESTED: ON —
TRIP DATE: 3} 43- TRIP PICKUP TIME: _ C45 AM
PICKUP LOCATION: A
vestwarion: 00 _Institcte Ro Mrecestee MA |
TIME LEAVING DESTINATION: | “10° PY a
TIME BUS WILL ARRIVE BACK AT PICK UP: — Sb P M LE Seg
DROP-OFF / PICK-UP: ___________. OR BUS TO STAY:
(4 HR MINIMUM FOR DROP & PICK / 2 HR MINIMUM FOR BUS 0 STAY}
*NOTE—M & J BUS INC. RESERVES THE RIGHT TO REFUSE TO DO TRIPS AS DROP-OFES &
PICK UPS BASED ON THE LOCATIONS AND TIMES.
BASED ON THE INFORMATION ABOVE, THE COST, PER BUS, FOR THIS TRIP IS:
PURCHASE ORDER #: _———______. OR €.0.D.
M & J BUS INC. AND ITS EMPLOYEES ARE NOT RESPONSIBLE FOR ANY ITEMS LOST, STOLEN, OR LEFT ON
BUS.
TO RESERVE THE BUS/ES FOR THIS TRIP, PLEASE SIGN, DATE, AND FAX BACK TO US AT 860-537-2625
IF YOU HAVE ANY QUESTIONS, PLEASE CALL GREG CORDOVA @ 860-537-2622.
SIGNATURE: : DATE:
CONFIRMATION SIGNATURE (M & J BUS INC}
SIGNATURE: DATE:
M & J BUS INC.
TRANSPORTATION REQUEST FORM Eu HAN
PLEASE USE THIS FORM TO REQUEST BUS TRANSPORTATION. ALL ORDERS BEING PAID BY COLCHESTER PUBLIC
SCHOOLS MUST BE ACCOMPANIED BY A PURCHASE ORDER. CALL FOR A PRICE QUOTE. FILL IN THE FORM
BELOW AND FAX IT TO OUR OFFICE AT 860-537-2625. PLEASE SIGN THE FORM AS YOUR APPROVAL TO BOOK
THE TRIP AT THE QUOTED PRICE. WE WILL THEN BOOK THE BUS AND RETURN A SIGNED COPY BY AN M&J
EMPLOYEE TO LET YOU KNOW WE RECEIVED THE ORDER. PRICES ARE SUBJECT TO CHANGE IF THE TIMES OR
DESTINATION OF THE TRIP IS CHANGED IN ANY WAY.
BILLING TIME IS 4 HR BEFORE DEPARTURE TIME AND CONTINUES THROUGH % HR AFTER RETURNING TO
‘DEPARTURE POINT.
TODAYS DATE: | 02] 1) / 25
PERSON PLACING ORDER: SSL UK) ener’
SCHOOL OR ORGANIZATION: BA
PHONE NUMER: ( § ) 531-23 18
NUMBER OF BUSES REQUESTED: One—
TRIP DATE: YAP sew PICKUP TIME: 45 AM
PICKUP LOCATION: BA
pesination: [00 [nS tte, Ral Vor chester MA
TIME LEAVING DESTINATION: (PM
TIME BUS WILL ARRIVE BACK AT PICK UP: 6 PM
DROP-OFF / PICK-UP: OR BUS TO STAY:
(4 HR MINIMUM FOR DROP & PICK / 2 HR MINIMUM FOR BUS TO STAY}
*NOTE—M & J BUS INC. RESERVES THE RIGHT TO REFUSE TO DO TRIPS AS DROP-OFFS &
PICK UPS BASED ON THE LOCATIONS AND TIMES.
BASED ON THE INFORMATION ABOVE, THE COST, PER BUS, FOR THIS TRIP IS:
PURCHASE ORDER #: ___.—______________. OR C.0.D.
M & J] BUS INC. AND ITS EMPLOYEES ARE NOT RESPONSIBLE FOR ANY ITEMS LOST, STOLEN, OR LEFT ON
BUS.
TO RESERVE THE BUS/ES FOR THIS TRIP, PLEASE SIGN, DATE, AND FAX BACK TO US AT 860-537-2625
IF YOU HAVE ANY QUESTIONS, PLEASE CALL GREG CORDOVA @ 860-537-2622.
SIGNATURE: DATE:
CONFIRMATION SIGNATURE (M & J BUS INC)
SIGNATURE: DATE:
veut +)
FIRST Robotics Competition Event 2
Friday, March 21- March 23 Worchester Polytechnic Institute
March 21- Pit Set-Up
SCHOOL VAN: T Praisner will pick up Roadie Group of 7 students and 1 additional
mentor to travel to WPI to set up the pit in preparation for competition. 2 Mentors will
drive separately with the team trailer. Leave Bacon at 3:30 pm for competition site at
URI Keaney Gym, 85 Keaney Rd, Kingston, RI. Group will be at competition site for pit
set up and practice matches from 5-9:00 pm. Van will leave at 9:00 pm. Group will stop
for dinner on the way home and return to Colchester by 10:00 pm for parent pick up.
March 22- Team Travel to WNE
M and J BUS will pick students and mentors up and leave Bacon Academy at 6:45 am
for WPI competition site. Bus Pick-up at WPI will be 7:00 pm. Bus will transport all back
to Colchester for a 8:15 pm pick up by parents. Lunch and dinner will be provided by the
team on site.
March 23- Team Travel to WNE for Day 2 of Competition
M and J BUS will pick students and mentors up and leave Bacon Academy at 6:45 am
for WPI competition site. Bus Pick-up at WPI will be 6:00 pm. Bus will transport all back
to Colchester for a 8:00 pm pick up by parents. Lunch will be provided by the team on
site and the bus will stop for dinner on the way home.
Supervision Information:
John L Spaulding 860-234-7058
Alan C Mocksfield 860-949-3292
Jason Belding 860-391-1581
Seth Crampton 860-681-6075
Bradley Graham 860-373-6110
Mark Noniewicz 860-917-8010