Field Trip Request Field Trip Request for all Grant Parish Public Schools. Δ Step 1 of 4 25% Trip Details Please complete the information below to request a school trip. Name of Person Completing Form(Required) First Last Email(Required) This email will receive confirmations and follow-ups.Name of School(Required)Select SchoolCentral OfficeGeorgetown HighGrant Junior HighGrant HighMontgomery HighPollock ElementarySouth Grant ElementaryVerda ElementaryTrip Destination(Required)Venue name only (example: Alexandria Zoo).Destination Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Enter the full physical address for the destination.Departure Date(Required) MM slash DD slash YYYY Departure Time(Required) Hours : Minutes AM PM AM/PM Use AM/PM (example: 7:30 AM).Return Date(Required) MM slash DD slash YYYY Return Time(Required) Hours : Minutes AM PM AM/PM Use AM/PM (example: 3:15 PM).Purpose(Required) Academic Sports Band Other Trip Sponsor Name(Required) First Last Trip Sponsor Position/Title(Required)Trip Sponsor E-mail(Required) Trip Sponsor Cell Phone(Required)Cell phone preferred for day-of-trip contact.Trip Objective(Required)Briefly explain the educational/organizational objective (1–3 sentences). Attendees & Student Needs Enter estimated counts. If applicable, provide special needs information and upload required documents. Organization (optional)Example: Club name, Team name, Band, Grade level, etc.Number of Students(Required)Number of Adults(Required)Total Passengers(Students + Adults).Student List Upload (PDF Only)(Required)Accepted file types: pdf, Max. file size: 1 GB. Upload a PDF roster that includes student names (and grade level if available).Upload Additional File Here Drop files here or Select files Max. file size: 1 GB. Are there students with special needs?(Required) Yes No Number of Students with Special Needs(Required)Required only if you selected Yes.Will wheelchair accessibility be needed?(Required) Yes No Number Needing Wheelchair Accessibility(Required)Required only if you selected Yes.This field is hidden when viewing the formNurse Notes / Medical Verification(Required)For School Nurse Use OnlyNames of Chaperones (optional)Optional: list chaperone names if known at time of submission.Trained Medical Personnel First Last Name of trained medical personnel accompanying the trip (if applicable). Transportation & Costs Select a transportation type to display the correct fields and complete cost details. Type of Transportation(Required)BusPersonal VehicleCost of Trip per Student (optional)Numbers only. Leave blank if no cost.Are meals included in cost? Yes No Cost of Meals(Required)Required only if you selected Yes.Miles Traveled (Round Trip)(Required)Bus trips only. Enter total round-trip miles.Bus Driver InformationBus NumberBus Driver's NameBus Driver Pay Add RemoveClick + button to add additional Bus Drivers Driver Information Personal Vehicle Only: Driver must be at least 21 and must upload a valid license and proof of insurance. Driver's Name(Required) First Last Driver's Insurance Carrier(Required)Driver's License Upload(Required)Accepted file types: jpg, png, pdf, Max. file size: 1 GB. Upload a clear photo or PDF of the driver’s license.Proof of Insurance Upload(Required)Accepted file types: jpg, png, pdf, Max. file size: 1 GB. Upload proof of insurance for the vehicle used.Driver's Signature(Required)Will there be a second driver? Yes No Second Driver's Name(Required) First Last Signatures Please sign to certify this request is complete and accurate. Trip Sponsor Signature(Required)
