Field Trip Request For PHS

Field Trip Request For PHS

Email address:* 

Date of Request:* 

Transportation Requested?*
What type of transportation is being requested?
 District School Bus
 District Van
 Charter Company
If requesting transportation, please enter number of buses need: 
If using a Charter Company, please list name: 
How will this trip be paid?*
If paid for using school district funds (* see previous question), please provide budget account code:
Requisition Completed:


Name of Person Responsible (teacher, coach, club adviser, etc.):* 

Extension Number or Phone Number:* 


Name of School:* 
 High School
 Middle School
 Durham Nockamixon



Start Date of Trip:* 

Time of departure from school:* 

Proposed arrival time at destination:* 

End Date of Trip:* 

Time of departure from event:* 

Proposed arrival time at school:* 

Purpose of the trip:*
Indicate additional destinations (ie., restaurants, etc.):

Number of students going on the trip:* 

List chaperones (limit of 5 adults per bus)(clearances must be confirmed):* 

Extra Notes:

Security Measure