Name ofTrip:

This Trip is recommended for: (indicate grade level or community organization that would be suggested. Example: grades 7-9 or Scout group, Brownies, Seniors.)

Suggested time of year for visit: Spring Summer Fall Winter

Reason to visit the area: (Check off all that apply – elaborate as necessary).

Geography Birds Animals Unique plants

Cultural Offerings Historical Significance

Several Outdoor Recreation/Environmental Education Attractions
(example:. Biodiesel Production Tour, Wall Climbing, Sod House, Trans Canada Trail)

Other items worth mentioning:

Facility Information: (Yes/No & whatever else you'd like to add)

Wheelchair accessibility: Yes No	Washroom facilities: Yes No
Lunchroom facilities: Yes No	Kitchen facilities: Yes No
Food Services: Yes No	Parking: Yes No
Public Transportation: Yes No	Other:

Directions to location:

Other things to do within 50 km distance:

Registration Information: (if appropriate – not necessary in all cases)

Registered by: (example: phone park office, email, on site)

Cancellation Policy: (if applicable)

Payment by: (example: school div. purchase order, cheque, cash) (if appropriate – not necessary in all cases)

Guiding or Hosting Available through: (example: contact local Wildlife Federation member John Doe @ 000-0000 or Chaplin Nature Centre at 111-11111 or contact the Sk. Provincial Parks Staff at 222-2222 or Town Office at 333-3333)

Contact information of the submitter:

Name

Organization Affiliation (example: Swift Current Comprehensive School or Southwest Naturalists)

SOEEA may need to contact you to clarify the submission information. Please indicate your contact preference and time.

Phone at home: Phone at work:

Email

Contact time preferred – morning afternoon evening

Are you agreeable to being contacted by other outdoor leaders directly? Yes No

THANKS for your submission.

Date of submission: (dd/mm/yy)