IJOA-E1 - STUDENT TRAVEL/FIELD TRIP AUTHORIZATION FORM

GROUP/TEAM NAME:  

NAME OF FACULTY/TRIP LEADER (MAKING REQUEST):  

DATE(S) OF PROPOSED TRIP:               # OF SCHOOL DAYS:                             # OF NIGHTS AWAY:

TRIP DESTINATION:

PURPOSE/BENEFIT OF TRIP:

TRANSPORTATION ARRANGEMENTS:

# STUDENTS:                     

#CHAPERONES:                            # SCHOOL STAFF:                      #PARENTS/OTHER:

ARRANGEMENT FOR MIXED GENDER SUPERVISION:

COST PER STUDENT:

DESCRIPTION OF ANY FUNDRAISING:

DO ALL MEMBERS OF THE GROUP/TEAM HAVE AN OPPORTUNITY TO PARTICIPATE?  - []YES  NO

IF NOT, DESCRIBE CIRCUMSTANCES:

FOR OVERNIGHT TRIPS:

? ALL PARENT/OTHER CHAPERONES HAVE ATTENDED VOLUNTEER TRAINING

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DATE/TIME OF PRE-TRIP CHAPERONE MEETING:

FOR OUT OF COUNTRY TRIPS: TRAVEL AND CANCELLATION INSURANCE ARRANGEMENTS (ATTACH COPY OF CONTRACT WITH INSURANCE AND CANCELLATION PROVISIONS HIGHLIGHTED)

APPROVAL OF TRAVEL:

Principal or AD: _______________________________________DATE: ______________

Superintendent: _______________________________________DATE: ______________

School Board: _______________________________________DATE: ______________

   All travel must first be approved and recommended by the principal or, in the case of athletic trips, the athletic administrator. The principal and athletic administrator are permitted to approve in-state day trips (no overnight stays) without the endorsement of the Superintendent or School Board.
   Out-of-state trips within New England and in-state requiring no more than one night's stay must be approved by the Superintendent.
   Board approval is required for Trips outside of New England; for all trips requiring two or more overnight stays; and for all trips requiring a per-student cost or fund-raising of $500 or more.
   Travel requests needing approval from the Superintendent of Board should be submitted at least two months of the trip.

For more information see Policy IHOA

Adopted:

• March 10, 2015

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