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* 1. School District

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* 2. School Name

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* 3. School Address including County

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* 4. Teacher Name

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* 5. Teacher Email

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* 6. Teacher Phone Number

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* 7. Preferred date of field trip?

Date

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* 8. Number of students expected to attend the field trip

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* 9. Preferred bussing company, their contact information & any additional accommodations

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* 10. Would you still be willing to book a field trip in Spring 2025 if not awarded a transportation stipend?

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* 11. How did you hear about this program?

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* 12. Anything else that you would like us to know as part of your application?

T