Field Trip Request

Teacher Name:

Grade(s)/Class(es) Requesting:

Number of Students:

Number of Chaperones Needed:

Date of Request:

Date of Field Trip:

Destination(s):

Destination Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Education Purpose of the Field Trip (Please be specific):

Cost per Student:

# of Free Admissions:

Cost per Adult:

Cost per sibling (if permitted):

Time Departing Agape:

Departing Campus:

Burton Campus

Troy Campus

Time Departing Field Trip:

Time Arriving Back at Agape:

Transportation Needed:

Bus (only available 8:30 a.m. departure time - 2:00 p.m. return time)

Van

Special Instructions (uniforms, dress for weather, disposable lunch, stopping for lunch, etc.):

Classroom Coverage Needed

Yes

The foolishness of God is wiser than man's wisdom, and the weakness of God is stronger than man's strength.

1 Corinthians 1:25