Field Trip Request Form

The purpose of this form is to notify and request appropriate permissions for the trip and the form is to be completed by the WGTC Staff/WGTC Faculty Member/WGTC Student Organization Advisor.

Authorities taking students on a trip MUST complete a Field Trip Request Form at least two weeks prior to the trip. This will allow time to ensure appropriate approvals in each department/division and the routing of appropriate information to the Chief of Police for Clery tracking purposes. THEN, each participant, including the faculty/staff/advisor, MUST complete a Student/Advisor Field Trip Release Form and the link to this form can be found in the Field Trip Policy.

Name*

First NameLast Name

Email*

example@example.com

Cell Phone Number*

Emergency use only. It will not be released to students.

Please select field trip type:*

Class Field Trip / Off Campus Live Work Field TripStudent OrganizationStudent Life Field Trip

Request must be approved 7 business days in advance.

Program*

Are you the Department Chair?*

YesNo

Department Chair Email*

Please ensure email is spelled correctly. This is where their approval email will be sent.

Approving Dean*

Business Name*

Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Phone*

Please enter a valid phone number.

Number of Students*

To which task in your program does this activity relate? *

All field trips must match to a KMS standard. Field trips may be used as part of lab to enrich the program curriculum.

What is the objective of this activity?*

Must relate to a KMS standard. What does the instructor hope to accomplish with this activity.

Name of your Trip (e.g. SGA Conference)*

Please select field trip type:*

In-State TripOut of State Trip

Length of Trip*

Single Day TripOvernight Trip

Trip Destination (Hotel, Conference Center, etc.)*

Name of Hotel, Conference Center, etc)

Street Address (If going multiple locations, enter address of first stop)

CityState / Province

Postal / Zip Code

Transportation Type*

State Vehicle (Transported by Advisor)Charter VehicleEmployee Transporting Students in Personal Vehicle (Will need VP permission)Meet at Destination

Names of other staff/faculty members who will be attending trip:*

Campus/site where you will be departing for your trip*

Departure Date*

Date

Return Date*

Date

Please provide trip details including purpose of trip*

Upload travel itinerary*

What is the approximate cost of the trip? Will students incur any out-of-pocket expenses? If so, how much is the expected out-of-pocket costs?*

Please upload a list of students that will be attending the trip. We will use this list to match the field trip waivers we will receive.

Required information for each student:

First Name
Last Name
Email Address
Phone Number
Physical Address (no P.O. box)
Emergency Contact Name
Emergency Contact Phone Number

If list is not currently available for this request, please send updated list to:

Student Org/Student Life Trip: studentlife@westgatech.edu
Class Field Trip/Off Campus Live Work Field Trip: James.Perry@westgatech.edu AND the Dean of the school associated.

Upload list of required student information.*

Department Approval

First NameLast Name

Request Status:

ApprovedDenied

Comments

Approver 2 Name (if applicable)

First NameLast Name

Request Status:

ApprovedDenied

Comments

Field Trip Request Form

Approvals