School Trip Request Form

School Trip Request Form

Requests must be received by the central office two weeks prior to trip or request will be denied
General School Trip Details
Name of Person Completing Form*

First NameLast Name
Email*
example@example.com
Name of School*
Trip Destination*
example@example.com
Destination Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Departure Date/Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Return Date/Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Purpose*

AcademicSportsBand
Trip Sponsor*

First NameLast Name
Trip Sponsor Position/Title*
Trip Sponsor's E-mail*
example@example.com
Trip Sponsor's Cell Phone*
Format: (000) 000-0000.
Trip Objective*
Attendee Details
Organization*
Number of Students Participating in Trip*
Upload a PDF file of the list of students that will attend. ONLY PDF files are accepted
Student list upload*

Cancelof
Medical Needs
Medical File Upload

Cancelof
Are there students with special needs?*

YesNo
Number of Students with Special Needs
Will wheelchair accessiblity be needed?*

YesNo
Number of Students Needing Wheelchair Accessibility
Number Adults Participating in Trip*
Name of Chaperones (click +Add Chaperones to add more Chaperones)
Trained Medical Personnel*

First NameLast Name
Total Passengers
Additional Trip Information

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Cost Details
Cost of Trip per Student
Are meals included in cost?

YesNo
What is the cost of meals?
Type of Transportation*
- Driver(s) should be provided with student emergency contact information.
- Driver pay should be sent to the central office bookkepping dept with an additional 35% to cover costs.
Miles Traveled (Round Trip)
Cost per Mile
Total Bus Usage Fee
Fuel Cost per Mile
Total Fuel Cost
Esitmated Total to be Paid to the GPSB Transportation Department per Bus
Bus Driver Information (Click +Add Bus Driver to add additional Bus Drivers)
Driver must be at least twenty-one years of age. Driver must attach proof of insurance and a copy of valid drivers' license. The undersigned driver understands that his/her insurance is primary and will be held responsible for any liability resulting from a trip.
Driver's Name

First NameLast Name
Driver's Insurance Carrier
Driver's License

Cancelof
Proof of Insurance

Cancelof
Driver's Signature

Clear
Date

MonthDayYear
Date
Will there be a second driver?

YesNo
Once the school trip is approved, the second driver must sign the approved trip form in person.
Second Driver's Name

First NameLast Name
Second Driver's Insurance Carrier
Second Driver's License

Cancelof
Second Proof of Insurance

Cancelof
Trip Sponsor's Signature

Clear
Should be Empty:

School Trip Request Form

General School Trip Details

Attendee Details

Cost Details