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2340 F4/page 1 of 2 East Knox Local School District TRIP REQUEST CO-CURRICULAR/EXTRA-CURRICULAR Advisor Group Date of Request Date of Trip Destination Purpose of Trip Departure Time Return District Cost How Funded Student Cost How Paid Means of Transportation No. of Staff No. of Chaperones Trip Approved Signature Bus Scheduled Trip Disapproved The staff member in charge will have a COMPLETED EMERGENCY MEDICAL FORM for each student on the trip. Th...
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