Field Trip Request Form Geosciences Field Trip Request Form This form must be completed for all field trips requests. If you are unable to submit this form at least one month prior to date of trip, please contact the Geosciences Main Office Staff as soon as possible. Instructor & Course InformationInstructor Name(Required) First Last Course Number(Required) e.g. GEO SCI 100Term(Required)Fall 2024Spring 2025Fall 2025Spring 2026Fall 2026Spring 2027UWM Email(Required) Cell Phone #(Required)Cell phone numbers are collected to make communication with drivers easier and provide Wisconsin DNR with an emergency number when groups are within state parks. Trip InformationIs the trip participation voluntary or required for students?(Required) Required Voluntary Departure Location(Required) Lapham Hall (3209 N Maryland Ave, Milwaukee, WI 53211) Other Departure Date(Required) MM slash DD slash YYYY Departure Time(Required) Hours : Minutes AM PM AM/PM Trip Destination(Required)Please provide specific details (including all relevant addresses) for any and all stops on this trip. Bus charters CANNOT be booked until this information is provided.Activities on Trip Hiking Canoeing/Boating Camping Facility Tour Other — specify below Please select all activities that will be conducted on this trip. Geosciences Office Staff will use this to create liability waivers. If your trip activity was not listed above, please specify that activity below: Return Location(Required) Lapham Hall (3209 N Maryland Ave, Milwaukee, WI 53211) Other Return Date(Required) MM slash DD slash YYYY Return Time(Required) Hours : Minutes AM PM AM/PM Itinerary (OneDrive Link)(Required) Please include a OneDrive link to your trip itinerary here. Itineraries are quired to secure all bus charters. Attendance InformationPlease list all Instructors, Teaching Assistants, and Chaperones attending in the space provided below:(Required)Please note that all UWM instructors and teaching assistants MUST complete a travel authorization prior to the trip. Anticipated Number of Attendees(Required)Please include all students, instructors, teaching assistants, and chaperones in this estimate. If a chargeback to student PAWS accounts is needed, which students should be charged?(Required) All students on the class roster (regardless of their attendance) Only students who attend the trip Other Note: If there are certain students that have exceptions, please contact the Geosciences Office. Trip Arrangement NeedsWill transportation be needed for this trip?(Required) Yes No Transportation School Bus(es) Coach Bus(es) Rental Vehicle(s) GEO SCI Research Truck Other — specify below Select all transportation arrangement assistance needed. If your mode of transportation was not listed above, please specify below: Transportation DescriptionInclude details including number of vehicles and particular requirements for this trip. Will this trip require an overnight stay somewhere?(Required) Yes No Lodging Hotel/Motel Campsite Other Select all lodging arrangement assistance needed.If your lodging method was not listed above, please specify below: Lodging DescriptionPlease include details including number of rooms/campsites and particular requirements for this trip. Will any of the activities on this trip require a purchase of admission tickets or equipment rentals?(Required) Yes No Activity FinancialsPlease include details about any activities costs. Examples include canoe rental cost, Discovery World entry fee, Iron Mine tour, etc. Additional InformationPlease include any additional information you think would be important for Geosciences Office Staff to know about your trip.