CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
FIELD TRIP REQUEST (Las Positas College)
INSTRUCTOR NAME: DIVISION/AREA:
COURSE TITLE AND NUMBER: SECTION(S):
DESTINATION:
PLACE OR FIRM
STREET ADDRESS CITY OR AREA
PURPOSE
(Be Specific)
DEPARTURE DATE:
Day of the Week
Month
Date
Year Time am/pm
ESTIMATE RETURN:
ASSEMBLY POINT:
Las Positas
Chabot
Destination
Other
(identify)
(TIME) (A.M.-P.M) (AND DATE)
ESTIMATED NUMBER
OF STUDENTS:
VEHICLE NEEDED*:
Van (15 passenger) Bus (25 passenger) Rental Vehicle Other (
District Vehicle)
*Check Box if a District Vehicle/Gas Card Request Form has been submitted to M&O Dept.:
(DATE) (INSTRUCTOR SIGNATURE)
APPROVAL
DIVISION DEAN VICE PRESIDENT PRESIDENT (Class III & IV)
(DATE) (DATE) (DATE)
Account Number
1.
Rescheduling of field trip from approved date indicated above must be approved by the Office of Academic Services.
2.
Requests for chartered bus transportation will be confirmed by the Office of Administrative Services.
3.
Arrangements for van transportation shall be made by instructor with Maintenance & Operations Department.
4.
A college first aid kit must be in the possession of the instructor while on a field trip.
CLASS IV - OUT OF STATE, activities conducted outside
the state of California. Requests must be submitted at least
SIX WEEKS prior to the date of the trip.
CLASS II - Field trips are IN-DISTRICT activities off
campus,but
limited by boundaries of the Chabot-Las
Positas Community College District (Castro Valley,
Hayward, San Leandro, San Lorenzo, Union City,
Livermore, Pleasanton, Dublin and Sunol).
- Field trips are IN-STATE, OUT-OF-DISTRICT
outside boundaries of the Chabot-Las
Positas Community College District. Requests must be
submitted at least ONE MONTH prior to the date of the trip.
CLASS I - Field trips are ON-CAMPUS activities limited to
College campus. Authorization is granted thr
ough the
Class I (On Campus)
Class II (In District) Class
III (Out-of-District)
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signature
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