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HICA Educational Summary

(To be completed by supervising teacher(s) and submitted to the Principal prior to activity).  Keep on file for category a and forward to Superintendent as notification for category b trip.  Attach to approval-in-principle application form for category c,d).


Description and Objectives of Activity:


Activity fits into the

curriculum.


Cost of Activity:


Source of Funds:


Planned Lead-Up Activities:


Planned Follow-Up Activities:


Names

Qualifications

Responsibilities


(if more, attach List)

Student Behavioural Expectations: It is expected that students will:


Number of Students Participating:

Grades:.


Teacher Coordinator:


Number of Students per Supervisor:


Parent permission forms will be distributed on:

Returned by (Date)


Parents notified of risks involved

Yes

No


Prepared for USIC by: Aon Reed Stenhouse

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