100 East Third Street, P.O. Box 578 Piketon, Ohio 45661 Phone: 740-289-4171
475 Western Avenue Chillicothe, Ohio 45601   Phone: 740-702-3120
View Ross Pike ESD & SST 15
Ross Pike ESC Field Trip/Community Outing Form
This online form should be completed for each field trip and/or community outing that you would like for us to consider for your class. Any request prior to January 1st, must be completed by September 30th. Any request from January to May, must be completed prior to January 1st.


Teacher Name
Email for reply
Supervisor who should receive this request.




Destination
Date that the trip is planned
Learning Outcomes/Content Standards that are addressed through this trip.
Will transportation be required for this trip
If transportation is required, have you spoken to the transportation coordinator to estimate the cost of the bus
Estimated transportation cost of trip to the ESC
How will the trip be funded.


Estimated cost of the trip to the ESC, not including transportation
Your Name:  
Your Email:  

To validate your submission, please type the answer to the following question:


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