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Old Richmond Elementary School


									                         STUDENT EDUCATIONAL TRIP REQUEST FORM
                            OLD RICHMOND ELEMENTARY SCHOOL
     This form should be completed at least 2 weeks prior to the requested trip and given to the principal for approval.

Student Name:       _________________________________________             Grade:           ____________________________

Destination:        _________________________________________             Teacher:         ____________________________

Dates of Trip:      _________________________________________             # of Days:       ____________________________
Objectives of       ___________________________________________________________________________________
this Trip:
(Summary only –     ___________________________________________________________________________________
details will be
provided on         ___________________________________________________________________________________
proposal)                 (North Carolina Standard Course of Study:

Parent Name:            _______________________________________           Telephone #:         ________________________

Parent Signature:       _______________________________________           Date Submitted:      ________________________

There is no substitute for the uninterrupted personal contact between teachers and students in the classroom environment
where learning experiences are carefully planned by the teachers. Even though students may make up class work missed
because of absences, they may never be able to replace the educational, cultural and social contacts which they would have
experienced through face-to-face instruction and class participation. Students with good attendance generally achieve
higher levels of learning than those with poor attendance. (WSFCS AR 5110)

A valid educational opportunity can be granted as an unexcused absence so long as the student’s parents or guardians
comply with the following guidelines:

□   All educational trip requests must be submitted using this form to the school principal at least two weeks prior to the
    planned trip. A parent or guardian may not assume an educational trip has been approved until the submitted approval
    form has been returned.

□   A maximum of five (5) days per academic year (August – June) will be considered for excused absences due to
    educational opportunities.

□   No requests for educational trips will be approved during school testing windows including but not limited to the last
    week of each quarter and during End of Grade testing (grades 3-5) in May. See the on-line school calendar for specific
    dates each year.

□   The student’s parent or guardian must submit a written statement explaining how the experience will enhance the
    student’s knowledge or understanding of one or more subjects contained in the NC Standard Course of Study.

□   Requests for educational trips to the same location visited in a prior school year will not be approved for a second time.

□   School work missed as a result of an approved educational trip is the responsibility of the student. After a student’s
    return, make-up work must be submitted within a time frame equivalent to the number of school days approved for the
    trip (i.e., for a two (2) day trip, two (2) school days will be granted for make-up work to be completed).

□   The student must turn in a daily journal or project from the trip detailing the educational activities they engaged in each
    day and the knowledge he/she has gained from the education experience. This journal / project must be submitted to
    the principal within a time frame equivalent to the number of school days approved for the trip.

□   Excessive absences in the current or prior school years can impact the approval of an educational trip request.

For school use only:
Principal’s Approval:      ____ Approved*          ____ Not Approved           Signature: ____________________________
Reason Not Approved:       ______________________________________________________________________________
*The trip will be counted as an excused absence, as long as all make-up work and a trip project are submitted on time.
                                         EDUCATIONAL TRIP PROPOSAL
                      (North Carolina Standard Course of Study:
     Please complete the top portion of this proposal and submit to the principal at least 2 weeks prior to the planned trip.

Student Name:
Grade:                                                             Teacher:

                      ____/____/____         ____/____/____          ____/____/____         ____/____/____          ____/____/____
Planned Daily
(up to 5 days)

                                        Be sure you align the activities to the curriculum for your child’s grade level.
How do the            Use the link above to the North Carolina Standard Course of Study to find objectives by grade level and subject.
support your

Description of         Daily Journal             PowerPoint Presentation            Other: _______________________________
Student Project:

(check the type of
project & describe
what the student
will do)

                 For school use only: All work will be due in a time frame equivalent to the number of days missed.
  Subject                                            Assignment                                               Teacher







                  Make-up work may be provided prior to or immediately following the trip (teacher’s discretion).
     Make-up work will be provided prior to the trip.                Make-up work will be available when you return to school.
                            Make-up work due date for approved trip: ________________________
                                 Work turned in after this date will be counted as late or as a zero.
   The following specific categories of trips will not be approved as educational trips:

   1. Shopping

   2. Hunting

   3. Fishing

   4. Visits to Relatives

   5. Local or State Fair

   6. Sporting Events (spectator)

   7. Events or places which could be visited outside of school time because they are nearby and/or
      available during substantial hours beyond the school day.

   8. A trip to an educational site for which a previous request has been approved. Site in this
      instance refers to a specific place; for example, it would be possible to schedule several trips to
      New York City without visiting the same sites.

   9. A trip of more than five (5) school days duration. Absences beyond five (5) days will be
      recorded as “unlawful” or “unexcused”, as appropriate, and subject to provisions outlined in
      Attendance Policy AR 5110, Part V.

   10. Accompanying the family to locate a new home due to a planned move.

   11. A trip taking place during the district’s testing windows including but not limited to the last
       week of each quarter and during End of Grade testing (grades 3-5) in May. See the on-line
       school calendar for specific dates each year.

   12. Approval for “Take Your Daughter/Son to Work Day” will only be approved once during a
       student’s school career at Old Richmond unless the parent’s job location and/or position


Parents wishing to have their children excused to participate in competitions or activities of various
kinds, i.e., athletics, arts, academics, etc., may apply for permission, using the same form as other
educational trips. The same factors will enter into the final decision as are indicated elsewhere on this
form. Participation in a competition or educational activity may be excused even if the location of the
competition or activity is at the same site as a previous event, providing the parent submits
documentation or other evidence showing the student’s activity will result in enhanced skill
                                     Curriculum Suggestions by Grade Level
Kindergarten:                            1st Grade:                                2nd Grade:
Five Senses                              Science & Social Studies:                 Math:
Communities/Community Helpers            Needs of living things                    Counting, ordering, comparing &
Holidays and Traditions around the       Animals and plants                        estimating numbers (0-200)
world                                    Holidays around the world                 Odd and even Numbers
Healthy Me                               Different cultures                        Problem solving & number sentences
Weather                                  Solid earth materials                     Measurement (in., cm, F°, ft., yd.)
Animals                                  Rocks                                     Venn diagrams and pictographs
Environment                              Soil                                      Repeating and growing patterns
                                         Then and now concepts                     Money (values)
                                                                                   Symmetry and congruency
                                         Math:                                     3 dimensional shapes
                                         Similarities and differences              Time (hour, half-hour and 5 minutes)
                                         Identifying shapes in the environment:    Probability
                                              Geometric shapes - trapezoid,        Fractions (halves, thirds, fourths)
                                              parallelogram & hexagon
                                              3 -D shapes: cone, cylinder, cube,   Science
                                                                                   Animal life cycles (butterflies &
                                              rectangular prism & sphere
                                         Knowing the value and names of coins:
                                         penny, nickel, dime & quarter
                                         Grouping objects and counting by 2's,
                                                                                   Plant life cycles
                                         5's & 10's
                                                                                   Social Studies
                                                                                   Community government
                                                                                   Then and now
                                                                                   The First Thanksgiving
                                                                                   Cultures around the world
3rd Grade:                               4th Grade:                                5th Grade:
Science                                  Math                                      Science
Soil                                     Place value to ten-thousands              Ecosystems (plant and animal life,
Plants                                   2 digit by 2 digit multiplication         human-environment interaction)
Earth                                    Median, mode, range                       Land and water (weathering and
Moon phases                              Coordinate grids and review of graphs     erosion, landforms such as mountains,
Stars & constellations                   Division (up to 3 digit by 2 digit)       rivers, deltas, floodplains)
Light                                    Area and perimeter                        Weather and climate (clouds, air
Bones & muscles                          Order of operations                       pressure, wind, instruments used to
                                         Expressions and variables                 measure weather, etc.)
Social Studies                           Fractions                                 Forces and motion (gravity, inertia,
Citizenship: people who make a           Decimals                                  momentum, acceleration, simple
difference in their communities          Perpendicular and parallel lines          machines, etc)
Roles of individuals and how             Equivalent measures (capacity and
individuals can initiate change in       length and weight)                        Social Studies
families, workplaces, communities                                                  American history
Relationship between people &            Social Studies                            Government
communities                              North Carolina history                    Geography
Basic economic principles                                                          Different cultures in North America
Technology used at home, school and      Health
in the community                         Nutrition                                 Writing
Analyze the role of real & fictional                                               Clarification
heroes in shaping the culture of         Science                                   Persuasive
communities                              Rocks and minerals                        Poetry
                                         Living things                             Journalism
                                         Electricity and magnetism

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