INSTRUCTIONS: DISTRIBUTION:
1. Submit form one week in advance. Originals – V.P. of Academic Affairs
2. Approval required before departure.
Revised 3/23/15 tmk
BAY MILLS COMMUNITY COLLEGE
Student Request for Approved Field Trip
*Instructor approval will be verified.
Student Name: ________________________________________________ Date: __________________
Leave BMCC: ________________________ Expected Return to BMCC:________________________
Time/Month/Day/Year Time/Month/Day/Year
Destination:_______________________________________________________________________________
Instructor/Staff: ___________________________________________________________________________
Students Learning Objective(s):
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Instructor Approval*
Course Instructor Signature Date
*By signing this document, the instructor approves of the students absence from class for the period set forth above. Any student
receiving approval should be marked “Workshop” in Empower.
Student Signature_____________________________________ Date:_______________________________
V.P. of Academics: ____________________________________ Date:_______________________________
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