Fillable Application for Field Experience (City of Oakland)

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Application for Field Experience (City of Oakland)

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The Application for Field Experience (City of Oakland) form is 1 page long and contains:

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U.S.A. forms for City of Oakland

BROWSE CITY OF OAKLAND (CA) FORMS

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DeSoto Parish School Board
Application for Field Experience
NOTE: Waivers from home must be in the hands of the teachers and approval granted by the principal and the Superintendent or his
designee ILYH school days or more before students and teachers are allowed to leave on any trip.
SCHOOL _________________________________________ DATE_____________________________________
TEACHER(S) IN CHARGE______________________________________________________________________
FIELD EXPERIENCE LOCATION________________________________________________________________
DESTINATION CITY & STATE__________________________________________________________________
DATES OF TRIP_______________________________________________________________________________
ANTICIPATED LEAVE TIME_____________ ANTICIPATED TIME OF RETURN______________________
NUMBER OF STUDENTS TO MAKE TRIP ______________ GRADE(S)________________________________
PLAN OF CONVEYANCE – Please complete the appropriate section & attach all requested documentation
Activity Bus _____
Name of Bus Driver(s)
__________________________________
__________________________________
__________________________________
__________________________________
*Car_____ (Attach items listed below)
*Copy of Insurance Card_____
*Proof of Insurance Statement_____
*Copy of Driver’s License_____
Other_________________________
(If charter bus, attach a Certificate of
Insurance from the bus company, naming
DPSB as “Additional Insured” with a
minimum liability limit of $5,000,000.)
A SUBSTITUTE TEACHER IS REQUIRED _____ YES _____ NO
FUNDING SOURCE(S)______________BUDGET ADMINSTRATOR'S SIGNATURE________________________________
CHECK ONE:
_______*EDUCATIONAL FIELD EXPERIENCE _____ACADEMIC COMPETITION
*Request for Educational Field Experiences require the attachment of documentation
illustrating the correlation to the Common Core State Standards/GLE's (Summary of lesson and activities)
NAME OF COMPETITION and/or PURPOSE OF FIELD EXPERIENCE
_______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
SIGNED___________________________________________ ______ DATE______________________________
Teacher(s) in Charge
PRINCIPAL’S SIGNATURE_________________________________ DATE______________________________
#Forward Applications to Student Learning Department
_________ Correlated to Curriculum _________ Not correlated to Curriculum
SUPERVISOR/DIRECTOR ________________________________________DATE________________________
SUPERINTENDENT OR DESIGNEE_________________________________DATE_______________________
Revised March 2014
(Copy of liability insurance needed)
(Attach Documentation)
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Application for Field Experience (City of Oakland)

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Completed 4 March 2022

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