School Information:

School Name:

Chaperone Name & Contact Information
It is required to have at least two chaperones on every campus visit.


Grade Level

Number of Students
(Minimum of 20 & Maximum of 40)

Do you wish to have Cal-SOAP provide lunch for the students, the day of the campus visit?
If “No”, it is up to the school staff to make arrangements for student lunches.

College Campus Information:

Name of Campus:

Date of Visit: