COAST COMMUNITY COLLEGE DISTRICT
FIELD TRIP REQUEST		 Date:

*Campus:  CCC          GWC         OCC
INSTRUCTIONS:
  1. Please complete a separate request for each field trip.
  2. Field trips requiring District transportation and/or Board Approval must be submitted FOUR WEEKS PRIOR TO DATE OF TRIP.  BOARD APPROVAL and a CLASS ROSTER are required for all OVERNIGHT TRIPS, OUT OF THE UNITED STATES TRIPS AND/OR TRIPS INVOLVING EXPOSURE TO HAZARDOUS CONDITIONS.
  3. Under no circumstances shall an instructor transport students in his/her own personal car without first obtaining approval from the appropriate administrator.
  4. IT IS NECESSARY TO CALL TRANSPORTATION DEPARTMENT (714) 438-4691 FIVE DAYS PRIOR TO CONFIRM TRANSPORTATION ARRANGEMENTS.

* = Required field
 
1.  Instructor Name:  *
   Instructor Email: *		  
Telephone #   Office: 		 
Home: 
2.  Date(s) of Trip:  * Means of Transportation:
3. Overnight trip or trips involving hazardous conditions?
   Yes      No		 Board Approval Date:
4. Day, Date and Time of Departure from College
   		Day, Date and ARRIVAL time AT College
5. Class/Program
    		Ticket No.
 No. of Passengers
 No. of Disabled Passengers
6. Regular Class Location
    		(Room No.)
 Regular Day(s) and Time Class Meets
7. Describe purpose of trip/itinerary
   
8. Is this trip in lieu of a regularly scheduled class meeting?    Yes      No
    If yes, date class is NOT meeting  
9. Location of Departure:
    CCC
    		 
GWC
  
OCC
    If Other: If Other: If Other:
10. Exact name and address of trip destination (street address, city, park, campground, beach, etc.)
    
     Phone no.: 
11. The trip is: Required for the course Optional Community Services
      The trip: Requires a fee $ Does not require a fee
ESTIMATED COST $

*
Division Chairperson or Area Associate Dean's Email Address

If all the information is correct, you may click on the Submit button below.  Please note that your form will be submitted to the Division Chairperson or Area Associate Dean whose email you provided above.