DOMESTIC INFORMATION REQUEST

Field Studies Council, Castle Head Field Centre, Grange-over-Sands, LA11 6QT
Tel: 015395 38120 Fax: 015395 36662
Email: shirleymartin.ch@field-studies-council.org

Please return this form by Monday 3rd November if possible so that relevant
information can be passed to the teaching team and kitchen staff.

SCHOOL/COLLEGE NAME: Cockshut Hill Technology College

COURSE: AS/A2 Geography

Arrival date: Mon 17th Nov 08 Departure date: Fri 21st Nov 08

Approx. time: lunch Approx. time: lunchtime

(with own packed lunch)

Please ensure that you complete the transport section

TRANSPORT: (Please delete or complete as necessary)

The students will arrive by car/train/public bus/coach/minibus

(Please notify us at least one week in advance if you need collection from Grange-
over-Sands railway station.)

Please indicate if your transport will be available for use on the course.
YES/NO

Ethnic origin: please indicate the number of students in each group (This
information is useful to us when applying for funding and grants)
White British
Irish
Another background
Asian or Asian British Indian
Pakistani
Bangladeshi
Other Asian background
Black or British Black Caribbean
African
Other Black background
Chinese
Mixed race group Black Caribbean and
White
Black African and White
Asian and White
Other ethnic group (please
specify)
Unknown or undeclared
DIETARY REQUIREMENTS
Please indicate any visitors who have special dietary requirements, e.g. vegetarian, food
allergy etc. Please list foods students CANNOT eat.

NAME: DIETARY REQUIREMENTS:

EMERGENCIES:
In the event of a serious incident involving a member of the group that you are
sending to the Centre, your organisation may have its own procedure. This may
involve a contact person within your organisation (rather than a relative of the group
member). If this is so, please provide the following information:

Name of contact person:

Position in organisation:
Contact Address:

Contact Telephone number:

(day and night)

For Health and Safety purposes, it is important that you have properly
completed the sections of this form concerning Medical Information and
Emergency contacts. All such information will be treated as confidential.

Please note:
 Smoking is not permitted in any of the Centre buildings.
 Chewing gum is not permitted anywhere on site.
 Only alcohol bought in the Castle Head bar may be consumed on the premises
- in the designated areas and by staff over 18 only, and not students on school
trips.
 For safety and security reasons we no longer allow mobile phones at the
Centre unless by prior arrangement with you as the School Group Leader. If
you decide to allow your students to bring mobile phones, this must be agreed
with the Centre beforehand.

ORGANISER’S SIGNATURE: …………………………………………..

DATE: …………………………………………..