Bemidji Regional Interdistrict Council
Bagley P.O. Box 974 Kelliher
Blackduck 1615 NW 5th Street Lake of the Woods
Cass Lake-Bena Bemidji Minnesota 56601 Laporte
Clearbrook/Gonvick Phone 218-751-6622 Littlefork-Big Falls
South Koochiching Fax 218-751-6625 Mahnomen
Denny P. Ulmer, Director Waubun
FIELD TRIP REQUEST
Teacher Name: Site:
Date of Field Trip: Destination:
Transportation Arrangements (vehicles, drivers, paraprofessionals):
Meal Arrangements:
Estimated Cost (tickets, materials, etc. Submit costs on BRIC requisition form):
List learning concepts to be introduced/reinforced by this activity (how does this relate to the student's IEP?)
Parent Permission Obtained (list date/method):
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Approved: Not Approved:
Coordinator: Date:
Director: Date:
7/05
Comprehensive Special Education Services for North Central Minnesota Schools