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Oklahoma Energy Resources Board (OERB) Field Trip

2. Have you requested a field trip to the Oklahoma Aquarium through OERB?*

   1. Yes, and I am awaiting approval.
   2. Yes, and they have approved me already.
   3. No.

4. Name of School/Organization*

6. Mailing Address*

7. School/Org. Office Number*

9. City*

10. State*

11. Zip Code*

13. Your Name*

15. Your Email*

16. Your Phone Number*

20. Arrival Date*
    Arrival Date

21. Arrival Time*
    -- Select One --10:00 AM10:15 AM10:30 AM10:45 AM11:00 AM11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM or later

22. Departure Time
    -- Select One --11:00 AM or earlier11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM4:15 PM4:30 PM4:45 PM5:00 PM5:15 PM5:30 PM5:45 PM6:00 PM or later (Tuesdays only)

24. Second Choice Arrival Date
    Second Choice Arrival Date

25. Arrival Time for Second Choice Date
    -- Select One --10:00 AM10:15 AM10:30 AM10:45 AM11:00 AM11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM or later

26. Departure Time for Second Choice Date
    -- Select One --11:00 AM or earlier11:15 AM11:30 AM11:45 AM12:00 PM12:15 PM12:30 PM12:45 PM1:00 PM1:15 PM1:30 PM1:45 PM2:00 PM2:15 PM2:30 PM2:45 PM3:00 PM3:15 PM3:30 PM3:45 PM4:00 PM4:15 PM4:30 PM4:45 PM5:00 PM5:15 PM5:30 PM5:45 PM6:00 PM or later (Tuesdays only)

28. Grade Level(s)- Select all that apply.*

    1. K
    2. 1st
    3. 2nd
    4. 3rd

    1. 4th
    2. 5th
    3. 6th

    1. 7th
    2. 8th
    3. 9th

    1. 10th
    2. 11th
    3. 12th
30. Expected Number of Students (Total)*

31. Number of Chaperones

    Can include teachers, bus drivers, parents, or any other adult you choose.

35. Will you have more chaperones than the number required?*

    1. Yes
    2. No

36. Chaperone Policy*

    The aquarium requires one chaperone for every 5 students in Pre-K through 2nd grade, and one for every 10 students in 3rd-12th grade. OERB will only pay the admission for required number of chaperones. Additional chaperones can pay their own admission and receive the field trip rate ($10 plus tax), however they may not attend Oklahoma's Oceans, the required OERB program.

    1. I understand the chaperone requirements.
38. Will you be attending with other OERB-certified teachers?*

    1. Yes
    2. No

39. Accompanying Teachers

    Please list any OERB-certified teachers that will be accompanying your school during the trip.

41. Additional Comments

Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field