EL PASO COMMUNITY COLLEGE
REQUEST FOR FIELD TRIP
**FIELD TRIPS CAN PLAY AN IMPORTANT ROLE IN THE INSTRUCTION PROCESS.
FACULTY MEMBERS PLANNING FIELD TRIPS SHOULD SUBMIT “REQUEST FOR
FIELD TRIP” TO THE DIVISION CHAIR TEN WORKING DAYS PRIOR TO THE
SCHEDULED TRIP.**
TO:
Richard Webb
Dean of Math, Science and Career & Technical Education
FROM:
(INSTRUCTOR’S NAME)
DATE:
DISCIPLINE
DATE OF
REQUEST
DATE OF FIELD
TRIP
CLASS COURSE
NUMBER &
SECTION
NUMBER
FIELD TRIP
DESTINATION
GIVE A BRIEF DESCRIPTION OF FIELD TRIP IN RELATION TO THE COURSE OBJECTIVES:
NUMBER OF STUDENTS EXPECTED TO PARTICIPATE IN FIELD TRIP:
NO OF STUDENTS
PARTICIPATING IN
FIELD TRIP
SOURCE OF FUNDS
MODE OF
TRANSPORTATION
ESTIMATED ROUND
TRIP MILEAGE
INVOLVED
APPROVED BY:
(DIVISION CHAIR)
DATE
FIELD TRIP DISCLAIMER I HEREBY ACKNOWLEDGE THAT I AM SOLELY RESPONSIBLE FOR ALL CONSEQUENCES, WHILE TRAVELING TO (FIELD TRIP DESTINATION) WITH , ON (COURSE & SECTION) (DATE) FOR THE PERIOD COVERING (TIMES) THIS WAIVER INDICATES THAT I CANNOT HOLD THE INSTRUCTOR, CLUB OR CLUB SPONSOR OR REPRESENTATIVE, AND EL PASO COMMUNITY COLLEGE DISTRICT LIABLE IN CASE OF ACCIDENT OR INJURY TO MY PERSON AS A RESULT OF THE TRIP. STUDENT’S NAME 1 16 2 17 3 18 4 19 5 20 6 21 7 22 8 23 9 24 10 25 11 26 12 27 13 28 14 29 15 30 (WITNESS) (EPCC REPRESENTATIVE) (DATE) (DATE)