Office Of Shared Accountability Montgomery County Public Schools Rockville, Maryland

Office of Shared Accountability MONTGOMERY COUNTY PUBLIC SCHOOLS Rockville, Maryland 20850

FIELD TRIP ACCOUNTING

Receipt #

Date

1 /

9 / 09

INSTRUCTIONS: This form is designed to provide the field trip sponsor and the school financial agent with a record of money collected for each field trip. The sponsor should retain both original and a copy of this form along with copies of the receipt forms received from the financial agent attached to it. When the trip is completed, the original of the form, but not the copies of receipt forms, should be given to the school financial agent. Date submitted to office 05 / 21 / 09

School Name Shady Grove Middle School

School Number 521

Teacher’s Name Jeff Boone / Rob Bowden Destination

Grade Level 6

Outdoor Education - Smith Center (2 1/2 day trip)

List students participating and amount paid Student Name

Perm. Slip

Date of Trip 05 / 04 / 09

Column 1

Date Paid

Total paid

(continued) Student Name

Cash Check

Time

to

Column 2 Perm. Slip

Date Paid

Total paid

Cash Check

1.

䡺

$

✔ 䡺

䡺

21.

䡺

$

䡺

䡺

2.

䡺

$

䡺

䡺 ✔

22.

䡺

$

䡺

䡺

3.

䡺

$

䡺

䡺 ✔

23.

$

✔ 䡺

24.

䡺 䡺

$

䡺

䡺 䡺

䡺 䡺

䡺 䡺

䡺 䡺

26.

䡺 䡺

䡺 䡺

䡺 䡺

䡺 䡺

28.

䡺 䡺

䡺 䡺

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33.

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35.

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37.

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䡺 䡺

䡺 䡺

39.

䡺 䡺

䡺 䡺

4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

䡺 䡺 䡺 䡺

$ $

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$ $

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$ $ $

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$ $

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$ $

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$ $

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$ $ Total Column 1

MCPS Form 280-41, Rev. 2/04

$

0.00

25.

27.

29. 30. 31. 32.

34.

36.

38.

40.

䡺 䡺

$ $

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$ $

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$ $

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$ $

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$ $

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$ $

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$ $

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$ $

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$ $ Total Column 2

DISTRIBUTION: COPY 1/Financial Agent; COPY 2/Teacher. Keep three (3) years for audit purposes.

$

0.00

$0.00 Total Column 1 and 2