Field Trip Request Form

Please print this form, fill in & fax to (559) 539-2369



Teacher Name:   Today's Date:  
Grade(s):   Dates Requested: 1.

2.

3.
 

School Name:

    
Address:   Arrival Time:  
  Departure Time:  
Phone:   # of Students:  
FAX:    
E-mail:   # of Adult Chaperons:  

 

Please give a brief description of Field Trip Activities:

 

 

 

Are you aware that there is a $50.00/ day fee?    Yes        No

Will you need instructional support from the Circle J Host?    Yes         No

Administrative signature:                                                    Date:

Questions? Please contact Nancy Bruce, education coordinator at (559) 539-2263 or circlej@ocsnet.net.