Field Trip Requisition

Name of KCU Personnel Sponsoring Trip

First Name *

Last Name *

Phone *

Email Address

Department *

Course

Destination

Estimated Round Trip

Departure Date *

Return Date *

Method of Travel:

Bus

Van

Auto

Mini Bus

Is overnight travel expected?

Yes

Meals per Student (Price Calculator)

Breakfast allowance ($4.00)
Lunch allowance ($6.00)
Supper allowance ($8.00)

Number of Breakfasts

Breakfast Cost Subtotal

Number of Lunches

Lunches Cost Subtotal

Number of Suppers

Suppers Cost Subtotal

Total Cost

KCU Box#

Total Trip Fees Per Student (Estimated)

Total Estimated field trip fee per student (to be published in pre-registration schedule)

Supervisor

Comments

WELL PREPARED

“Thank you so much, Dr. Brickey! I was well prepared, both educationally and most importantly, spiritually. I will forever remember this experience. I pray I can continue to make Yancey School of Nursing proud as I practice my career.”

Nephtalie Fleur, Class of 2022

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