J P03:02 RCVD STUDENT TRAVEL----PRE-APPROVAL FORM

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1 J P03:02 RCVD STUDENT TRAVEL----PRE-APPROVAL FORM This fonn must be completed and approved by the principal and the superintendent or the superintendent's designee (Board where appropriate) prior to starting any fund raising activities. A minimum advance of 30 days notice is expected. The longer and more expensive the trip, the more advance notice should be given. School: -=S;..;.h~ip:-:rock7::':~H:.:.Iig",-h;.,.;S:;;c:.:..h7.0::.:01,-- Date: 12/4/11 Sponsor's Name Rachel Mercer-Smith Organization CCSDGlfted Education Program Trip Destination: Destination Imagination Global Finals, Knoxville, TN Departure Date: May 23, 201,.., Return Date: May 26, 201.,.,. Purpose of the Trip: Compete in the Destination Imagination Global Finals Competition in the event that students qualify Students will gain valuable problem-solving skills via the opportunity to showcase academic projects through international competition. 12 Number of 2 ---;::-:-::-:==,- Chaperones: How will this trip benefit students? Number of students making the trip: Trip Cost: approx. $ Mode of travel: -:-$714'-':,7.:...0:...; '---,-, Cost per student: $1, Airplane and bus How will funds be Navajo taco sales, raised penny drives, letters of solicitation, bake sales o Local Field Trip Requires principal approval Detailed Trip Itinerary must be attached. The itinerary must outline specific activities, with dates and times Extended Field Trip Requires Principal/Superintendent or Superintendent's DeSignee Approval o Unique Field Trip Requires Principal/Superintendent's Designee/CCSD Board approval Principal I support the educational value of this trip and recommend approval by the Superintendent or Superintendent's Designee and the CCSD School Board. Justification for support: r~ 4..e.~. < CCSD Board ApprovaUDisapproval Meeting Date

2 Shiprock Hie;h School Gifted DEPARTMENT OUT-OF-STATE TRAVEL PROPOSAL December 4, 2011 The following proposal outlines our trip to Knoxville, Tennessee May 23 rd through May 26 th, This proposal includes a general statement, cost estimation sheet, travel itinerary, fund-raising activities, eligibility requirements, emergency medical form, trip policies and directions. Ifyou should have any questions regarding this proposal, please contact me. Thank you. Rachel Mercer-Smith Gifted Education Teacher/ Destination Imagination Team Manager Shiprock High School mercr@centralschools.org GENERAL STATEMENT

3 One goal of an educator is to provide the opportunity for students to excel both academically and socially so they may reach their ultimate potential. The chance to perform and compete in a nationally recognized academic competition such as Destination Imagination is an excellent opportunity to motivate, challenge and drive students to the highest degree of excellence in academic, problem-solving and social skills. "Destination Imagination" (01) is an international problem-solving competition that emphasizes creativity, team work and perseverance. DI uses 21 st Century educational ideals while working with the educational standards. Students from al1 over the world compete in Destination Imagination, and over 1,000 teams from around the world compete at Global Finals. Additionally, students who compete in DI are placed in high regard by multi-national corporations such as Conoco Phillips and 3M. Participation in 01 creates unique learning opportunities for students, provides experience for their future careers and offers scholarship money to top contestants. In addition to the educational values students will gain, this is an excellent opportunity for students to learn more about themselves. Our students will perfonn and interact with thousands of other middle and high school students from around the country and the world. I believe this interaction is crucial to the social development of our students and an integral part of a balanced, well-rounded education. Any time an individual has the opportunity to travel outside his or her own environment, learning takes place. Visiting universities and historical landmarks, as well as improving one's knowledge and understanding ofnational history- are only a few educational experiences that occur with a trip of this nature. Since many of our students will be traveling to a part ofthe United States where they may never have visited, this is a great opportunity that will give our students a lifelong education. COST ESTIMATION: BASED ON 10 STUDENTS

4 A. TRANSPORTATION EXPENSE: (Flights (rom Albuquerque to Tennessee, alld shuttle service between Nashville and Knoxville. Parents will provide transportation to Albuquerque.) 12 round trip flights from Albuquerque, NM to Nashville, $5, Round trip shuttle service from Nashville to passenger $130 per day x 2 days (for transportation to and from Albuquerque Sunport) TRANSPORTATION ESTIMATE EQUALS: $6, B. (1) TEACHER, (1) CHAPERONES: Registration, housing, and meal $635 per person $ 1, $1,270 per meal x 4 meals $ (21unches, 2 dinners per adult) $55.00 $ DIRECTOR/CHAPERONES ESTIMATE EQUALS: = $], C. STUDENT EXPENSES: Student registration, housing and meal $635 per person $6, $6.00 PER MEAL X 4 MEALS (2 lunches and 2 dinners) $ ADMISSION TO ACTIVITIES '" see next page $ MISe.EXPENSES?? STUDENT EXPENSES ESTIMATE EQUALS $ 7, TOTAL ESTIMATED EXPENSES $14, TOTAL ESTIMATED COST PER STUDENT $ 1, (COST/I0 STUDENTS) STUDENT ACTIVITIES * THIS IS ONLY AN ESTIMATE. ACTIVITIES BEING CONSIDERED

5 MAY INCLUDE ONE OF THE FOLLOWING: Dollywood Amusement Park Mountain Adventure Course DI Challenge Camps TOTAL $ $45.00 $35.00 $ (APPROX.) DI TRAVE.L ITINERARY

6 DATE: EVENTS: TIME: LOCAT[ON: TUESDAY, MAY 22 Depart Tse Bit Ai 8:00 AM TBA Rest Stop in Cuba 10:30 AM Cuba Leave Cuba 10:45 AM Cuba Arrive at Albuquerque Sun port and check in 12:00 AM Albuquerque Lunch at the gate- Subway (2:30PM Albuquerque Depart Albuquerque SWlport 1:35 PM Albuquerque Arrive Nashvi1le Airport 6:35 PM Nashville Dinner in Burger King 6:45-7:15 Nashville Board Shuttle 7:45 PM Nashville Arrive Knoxville and check in 10:30PM Knoxville Roomcheck 11:00 PM Hotel WEDNESDAY, MAY 23 Wakeup/Breakfast 7:00AM Hotel Practice 8:30-9:30 Hote! DJ activities** 9:30-11 :30 AM UT lunch 12:00-1:00 PM UT Practice 1 :00-2:00 PM UT Dl activities 1 :30-4:30 PM UT Dinner 5:00-6:00 PM UT Opening Ceremony 7:00-8:30 PM UT Roomcheck 10:30 PM Hotel THURSDAY, MAY 24 Wakeup/Breakfast 7:00AM Hotel Practice 8:30-9:30 Hotel Instant Challenge Com(2etition 10:00-11 :30AM UT lunch 12:00-1:00 PM UT Practice I :00-2:00 PM UT D1 activities I :30-4:30 PM UT Dinner 5:00-6:00 PM UT 3M Duct tape Ball 7:00-9:00 PM UT Roomcheck 10:30 PM Hotel FRIDAY, MAY 25 Wakeup/Breakfast 7:00AM Hotel Excursion (see Student activities} 8:00 AM-5:00 PM TBA Dinner 5 :00-6:00 PM UT Practice 7:00-8:00 PM UT Dance or swimm ing 8:30-10:00 PM UT Roomcheck 10:30 PM Hotel SATURDAY, MAY 26 Wakeup/Breakfast 7:00AM Hotel Practice 8:30-9:30 Hotel Main Challenge Com~tition 10:00-1] :30AM UT lunch 12:00-1:00 PM UT Dl activities 1 :30-4:30 PM lit Dinner 5:00-6:00 PM UT Closing Ceremonies 7:00-9:00 PM UT Middle School D1 Festival 9:30-11 :30 PM UT

7 Roomcheck 12:00 Hotel SUNDAY, MAY 27 VVakeup/Breakfa~ Checkout ShuttJe to Nashville Airport Arrive Nashville Airport Check-in Lunch Burger King Depart Nashville Arrive Albuquerque Dinner- Pizza Hut Depart Albuquerque Rest Stop in Cuba Leave Cuba Arrive Tse Bit Ai Middle School 7:00AM Hote] 8:00AM Hotel 9:00AM Hotel 12:00 PM Nashville 12:00 PM Nashville 12:30 PM Nashville 2:15 PM Nashville 6:45 PM Albuquerque 7:15 PM Albuquerque 8:00 PM Albuquerque 9:30 PM Cuba 9:45 PM Cuba 12:00 AM Shiprock **DI activities are sponsored by the organization. They include life size chess and other games, moon simulations, Innovation Expo, pin trading, International Buddy Program, and designing and creating duct tape attire. EDUCATIONAL ACTIVITIES ARE UNDERLINED ALL ACTIVITIES AND MEALS TAKE PLACE AT THE UNIVERSfl'Y OF TENNESSES, KNOXVILLE UNLESS OTHERWISE NOTED. SCHEDULES FOR TIIURSDAY, FRIDAY AND SATURDAY MAY CHANGE SLIGHTLY ONCE OUR COMPETITION TIMES ARE ANNOUNCED. AS SOON AS OUR PERFORMANCE I ACTIVITY SCHEDULE IS COMPLETE, THE REVISED SCHEDULE WILL BE SUBMITTED TO THE PRINCIPAL. FUND RAISING ACTIVITIES BELOW IS A LIST OF UP-COMING FUND-RAISING ACTIVITIES THAT MA Y INCLUDE THE FOLLOWING: 1. Candy Gram Sales 2. Navajo Taco Sale 3. Donation letters to local businesses ALL FUND-RAISING ACTIVITIES WILL BE SCHOOL BOARD APPROVED PRIOR TO IMPLEMENTATION.

8 STUDENT TRAVEL This fonn must be completed and approved by principal and curriculum director (Board where appropriate) prior to starting any fund raising activities. A minimum advance of30 days noticed is expected. The longer and more expensive the trip, the more advanced notice should be given. Sponsor's Name: Amanda ChampanLSchool: TSE BIT A l MIDDLE SCHOOL Date: J112/11 Trip Destination: University oftennessee, Knoxville IN Departure Date: 5/22111 Return Date 5127/11 Purpose of trip: TO PERFORMCOMPETE IN THE DESTINA non IMAGlNATION GLOBAL FINALS. PLEASE SEE TRIP PROPOSAL. HOW WILL THIS TRIP Benefit Students: PLEASE SEE TRIP PROPOSAL Number ofstudents Making Trip:..:.,..l:1~O Number of Chaperones: 12 Trip cost: SEE PROPOSAL Cost For Individual Students (if appropriate): $ 1, PER STUDENT Mode of Transportation: AIRPLANE/SHUTTLE BUS How Will Fund Be Raise FUND- RAISERS AND OUT-OF-POCKET Detailed Trip itinerary must be attached that outlines specific activities with dates and times. 1 Principal's Approval I support the educational value ofthis and recommend it be approved by the Superintendent/School Board.

9 IMPORTANT ADDRESSES AND PHONE NUMBERS Destination ImagiNation, Inc S. Union Avenue Cherry Hill, NJ Destination Imagination Assigns teams to hotels. Once assignments have been made, the principal and parents will be given a list of contact numbers.

Day. Performance in the Park. Culinary Day

Day. Performance in the Park. Culinary Day Sports Statistics Day Festival of Music Marketing Day Engineering Day Performance in the Park Education Days Culinary Day Dear Educator or Group Leader, We are thrilled that you are considering a trip