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SASD Field Trip/ Transportation Request
A separate form will need to be completed for each Field Trip requested, even if the purpose is the same.
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* Indicates required question
Email
*
Your email
By checking "Yes", I am stating that I have read SASD Board Policy #121, and will adhere to all guidelines set forth in this policy. (Policy can be found on
www.southallegheny.org
under School Board>Board Policy Manual>100 Programs)
*
Yes
Required
Requested by
*
Your answer
Date of Field Trip
*
MM
/
DD
/
YYYY
Purpose of Trip
*
Athletics
Non-Athletics
Describe Trip
*
Your answer
Building
*
South Allegheny Elementary
South Allegheny Middle School
South Allegheny High School
South Allegheny Education Center
Destination and specific address
*
Your answer
Grade level(s)/ Organization
*
Your answer
Number of Students Participating
*
Your answer
Transportation Request
*
Bus
Transit Van (holds 9 + the driver)
Number of buses requested
*
Your answer
Students will leave the building at
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Time
:
AM
PM
Specific Pick-Up Location
*
Your answer
Students will return to the building at
*
Time
:
AM
PM
Specific Drop Off Location
*
Your answer
If applicable, please describe plans for lunch, including time and if transportation will be needed to lunch location.
Your answer
Teachers/ Chaperones/ Coaches Attending
*
Your answer
Substitutes Needed/For Whom
*
Your answer
Is this field trip being sponsored by a team, company, or organization?
*
Yes
No
Who is responsible for remitting payment? Please include name, address, and/or email.
*
Your answer
What, if any, are the anticipated costs to the District? (including substitute costs)
*
Your answer
What, if any, are the anticipated costs to the student and/or parent(s) or guardian(s)?
Your answer
What practical safety and security provisions have been established? What is the plan for communicating this to all who need to know?
*
Your answer
What arrangements have been made in the event of a cancellation of the field trip? (Cancellation insurance, notification of parents, refunds or other?)
*
Your answer
By checking this box, you are stating that appropriate parties will be notified and permission slips will be secured prior to attending the trip.
*
Yes
By checking this box, you are stating that you will return to the building by 2:00pm at the latest.
*
Yes
If requesting the District van, by checking this box, you are stating that you are an approved driver for the District.
Yes
Clear selection
Any additional comments or information
Your answer
To verify your transportation, please contact Lacey Hillegas at 412-385-2908 before 6PM. Evenings and weekends call 724-518-1774.
A copy of your responses will be emailed to the address you provided.
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