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Request for Approval of Field Trip

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					FIELD TRIP PROPOSAL, SUMMARY / APPROVAL FORM                                                                                                                           Attach Transportation Expense Worksheet

          NORTHWEST HIGH SCHOOL REQUEST FOR APPROVAL OF FIELD TRIP                                                                        2012-2013
                                                                                                                                                                                                        TODAY'S DATE
 DIRECTIONS: If your field trip includes transportation expenses, complete the appropriate transportation cost worksheet BEFORE completing this form. Complete all blue boxes on the page. This worksheet will calculate the total field
 trip expense and cost per student. Fields shaded yellow will auto-calculate your expenses.

                                                              FIELD TRIP SPONSOR(s) NAME(s):

                                                 FIELD TRIP DESTINATION (Name & Address):

                                                                               DEPARTURE TIME:                                                    DEPARTURE DATE:

                                                                                   RETURN TIME:                                                       RETURN DATE:

                                                                                                                                                                        If using MCPS or charter buses, attach transportation expense worksheet. If
                                  TYPE OF TRANSPORTATION (MCPS bus; Charter Bus; car, public transportation, etc.)                                                      parents are driving, attach names and insurance information.

                                                                                          Charter Bus Company (if applicable)

                                                                                                  Classes/Groups Participating

                                                                              * * * ENTER NUMBERS ONLY BELOW THIS POINT * * *
                         TOTAL NUMBER OF STUDENTS AND ADULT VOLUNTEERS (PAYING) WHO WILL PARTICIPATE:                                                                   Names of Chaperones:
                                             TOTAL NUMBER OF CHAPERONES (NON-PAYING) WHO WILL PARTICIPATE:
                                                                       TOTAL NUMBER OF FIELD TRIP PARTICIPANTS                                       0
 FIELD TRIP EXPENSE CALCULATIONS
                TOTAL MCPS BUS TRANSPORTATION EXPENSE, if applicable (from MCPS Transportation Cost Worksheet)                                                          TOTAL MCPS BUS EXPENSE
       TOTAL CHARTER BUS TRANSPORTATION EXPENSE, if applicable (from Charter Bus Transportation Cost Worksheet)                                                         TOTAL CHARTER BUS EXPENSE

                                                                     Admission Cost per person                                                                  $0.00   TOTAL ADMISSION EXPENSE
                                                                    Food Allowance per person                                                                   $0.00   TOTAL FOOD EXPENSE
                                                      TOTAL MISCELLANEOUS EXPENSES, TIPS, etc. (attach itemized list )                                                  TOTAL MISCELLANEOUS EXPENSE
                                                                                                                                                                        TOTAL FULL-DAY SUBSTITUTE EXPENSE ($17.26/hr x 7 hrs + 7.065%
                                             NUMBER OF FULL-DAY SUBSTITUTES REQUIRED                                                                            $0.00   FICA)
                                                                                                                                                                        TOTAL HALF-DAY SUBSTITUTE EXPENSE* ($17.26/hr x 3.5 hrs +
                                             NUMBER OF HALF-DAY SUBSTITUTES REQUIRED                                                                            $0.00   7.065% FICA)
                                                                                                                                                                           * Note: Substitutes may be employed on an hourly basis from a
                                                                                           TOTAL FIELD TRIP EXPENSE                                            $0.00       minimum 3.5 hrs/day - 7 hrs/day per MCEA Contract. Schools are
                                                                                                                                                                           responsible for reimbursing MCPS for field trip substitutes at a rate of
                                                                                                                                                                           $17.12/hr + 7.65% FICA. [Reimbursement should be remitted to Division
                                CALCULATED FIELD TRIP COST PER STUDENT & ADULT VOLUNTEER (Paying)                                                              $0.00       of Controller using MCPS Form 203-2]

                      FIELD TRIP COST TO BE CHARGED PER STUDENT & ADULT VOLUNTEER (ROUND UP)                                                                   $0.00

                         SPONSOR SIGNATURE (Required): _______________________________________ DATE: ____/____/____
 FOR ADMINISTRATIVE USE ONLY:
 Business Administrator: ____________________________ Date: ___/___/___                                                          Approved
                                                                                                                                  Denied / Reason: _____________________________________________________
 ACCT # __________                                                                                                                   Principal's Signature: ___________________________________ Date: ____/____/____
Distribution: Original to School Financial Agent; Copies to: Sponsor, Attendance Secretary, Other__________________________________________________________________________________
FIELD TRIP PROPOSAL, SUMMARY / APPROVAL FORM                                                                                        Attach Transportation Expense Worksheet




Distribution: Original to School Financial Agent; Copies to: Sponsor, Attendance Secretary, Other__________________________________________________________________________________

				
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