Fillable Southern State Community College Field Trip Request

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Southern State Community College Field Trip Request

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FIELD TRIP REQUEST
CAMPUS_______________________ DATE OF REQUEST____________________
NAME__________________________________________
Purpose of Field Trip_____________________________________________________
_______________________________________________________________________
Destination______________________________________________________________
Dates of Field Trip: From_____________________ through______________________
School Days Involved________________ Estimated Distance_______________
(miles round trip)
Non-School Days Involved_________________
REASON FOR ATTENDING
_______________________________
_______________________________
ESTIMATED EXPENSES
Registration $__________________
Transportation $__________________
Other _________ $_________________
______________________________
_________ $__________________ ______________________________
TOTAL ___________________
REQUESTOR SIGNATURE_______________________________________________
______________________________ ____________________________________
Department Dean Signature
Approved______ Disapproved______
COMMENTS____________________________________________________________
_______________________________________________________________________
Revised 09/16
Please Note: Each participant will need to fill out and return the SSCC Field Trip Waiver
of Lability / Hold Harmless Agreement Form.
** Please contact the SSCC Webmaster at webmaster@sscc.edu for suggested updates or changes to this form **
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Southern State Community College Field Trip Request

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Completed 19 February 2020

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