# Permission-slip reading/preparation note

Actual school-provided form/reference: __________
Related notice/reference: __________
Trip date/destination: __________
Departure location/time: __________
Return location/time in each source: __________
Transportation: __________
Exact question for coordinator: __________
Actual coordinator/contact: __________
Actual response/date/source: __________
Corrected institution form if supplied: __________
Confirmed arrangements: __________
Actual form deadline/return route: __________
School receipt reference if supplied: __________

Complete the institution form separately. This note is not a consent form, signature or submission record.