V-51: Student Travel Request Form

  North Sanpete School District
Request for Student Travel Requiring Approval

of the Superintendent or Board of Education
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Note: Educators submitting this request should first read the North Sanpete School District Student Travel Policy. This form must be submitted prior to advertising or reservations for the planned outing.

Indicate Travel Type requested:
Superintendent Approval

  1. In-state overnight trips or short notice out of state competition (must cost less than $500 per student and not miss more  than two days of school) 

School Board Approval

  1. Preseason games more than 150 miles from Mount Pleasant
  2. Out of state trips
  3. Exceptions to limitations under Superintendent approval
  4. Other

School _____________________________________________________________


Teacher(s) Leading Trip____________________________________________________________________________________



Dates of Travel_________________________________________ Days of School Missed?_____________________________

How many other overnight trips has the group taken this year?___________________________________________________

This request will not be considered for approval or advancement without complete answers to the questions below:

Educational Justification: What are the educational objectives of this trip that cannot be replicated closer with less travel cost?



Standards for Participants: What are the academic and behavioral standards that must be met by participating students?



Safety: In what way will you insure the safety of students while traveling or participating in activities? (Describe special instructions to students, supervision guidelines to chaperones, etc.)



Lodging: Where will students be staying at night?



Number of Students Traveling?________________

Number of Adult Chaperones?________________ (must have same gender chaperones)

Date of Parent Meeting_______________________(Required for overnight travel)

Method of travel: (check all that apply)

School Vehicle (van, car, etc.)

School Bus

Charter Bus

Parent transporting their own children

Airline (outline ground transportation plan)________________________________________________________________

Other (specify)________________________________________________________________________________________

Participation by Student is: ☐ Optional       ☐ Mandatory

If overnight travel, have parents signed consent forms?

         ☐ Yes          ☐ No           ☐ No, but they will prior to departure

Financial: As a school sponsored activity, fee waivers apply.  How will you cover the potential costs of fee waivers?

How much must a student pay or fundraise to participate?

Total cost of the trip per students (if other funds are used)?

I have read the North Sanpete School District Student Transportation Policy, and I understand that I am responsible for the safety / well-being of students while on the proposed excursion.

__________________________________________________     _____________________
Signature of group leader (must be NSSD employee)                Date

I have reviewed the itinerary of the proposed trip and reviewed safety procedures with the supervising educator.  I have confirmed that no students will be penalized in any way if he/she cannot participate in this travel experience.  I recommend this travel to the superintendent.

__________________________________________________     _____________________
Signature of school principal                                                      Date

__________________________________________________     _____________________
Signature of Superintendent                                                       Date

__________________________________________________     _____________________
Board Approval                                                                          Date

Special conditions related to superintendent or Board approval:

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