Field Trip Form & Curriculum Evaluation

Have you previously attended an OERB workshop?(Required)

Yes

Teacher Name(Required)

First Last

School District(Required)

School Name(Required)

School Address(Required)

City State ZIP Code

Phone(Required)

Email(Required)

OERB Curriculum Taught:(Required)

Little Bits

Fossils to Fuel

Fossils to Fuel 2

Petro Active

Rockin' Ratios

CORE Energy Language Arts

CORE Energy Math

CORE Energy Science

CORE Energy Social Studies

Field Trip Information

Museum You Plan to Visit(Required)

Student Grade Level(s)(Required)

Number of Classes(Required)

Total Number of Students(Required)

# of Chaperones(Required)

Every student, teacher and chaperone must have a ticket to attend. The OERB will cover the cost of 1 chaperone per 5 students.

Mailing Address(Required)

The OKC Blue Staff will mail you the tickets prior to the game. You must provide your FULL MAILING address including street, city, state and zip code.

Email Address(Required)

The OKC Blue Staff will mail you the tickets prior to the game. You must provide your FULL MAILING address including street, city, state and zip code.

Contact Phone Number(Required)

The OKC Blue Staff will mail you the tickets prior to the game. You must provide your FULL MAILING address including street, city, state and zip code.

OERB Waiver of Liability

Please read carefully and sign.

School and school district indemnify OERB for the following:
-Any and all injuries/deaths incurred during transportation to and from OERB-sponsored trips/events.
-Any and all injuries/deaths incurred during OERB-sponsored trips/events.

The teacher should review acceptable standards of conduct with the students in advance of the trip. The teacher has primary responsibility of the conduct of the students. If students steal, deface property or behave in an inappropriate manner during OERB-sponsored trips/events, OERB retains the right to exclude school/school district from future participation in OERB-sponsored trips/events.

Please indicate that you agree and acknowledge this waiver by typing your name and date below.

Teacher Name(Required)

Full Name

Date(Required)

Curriculum Evaluation

Please do not fill out this form until you have taught the curriculum. Your response is requested to serve as a guide for further program development. Your assistance is appreciated.

1. Have you completed the OERB curriculum in your classroom this year?(Required)

2. How many years have you taught the OERB curriculum?(Required)

3. How much time did you spend teaching the curriculum?(Required)

4. How do you feel your students benefited from the curriculum?(Required)

5. Do you feel that the curriculum encouraged and maintained student participation? Why or why not?(Required)

6. Please describe any problems you encountered while teaching the curriculum.(Required)

7. Did you use any of the following materials to supplement the OERB curriculum? Please check all that apply.

Petro Pros (Petroleum Professionals in the Classroom)

The Energy Behind Finding Energy DVD

Petro Pete's Adventure Book Series (K-6th)

Petro Pete's Energy Adventure Activity Book (K-6th)

OERBHomeRoom.com

Video labs and virtual field trips on OERBHomeRoom.com

Other:

Respond to each of the following items by writing the number that best represents your opinion.

8. The degree to which the curriculum met the Oklahoma's Academic Standards(Required)

1 = Poor, 2 = Fair, 3 = Satisfactory, 4 = Good, 5 = Excellent

9. The degree to which the curriculum actively engaged students in the learning process.(Required)

1 = Poor, 2 = Fair, 3 = Satisfactory, 4 = Good, 5 = Excellent

10. The degree to which the curriculum was comprehensive.(Required)

1 = Poor, 2 = Fair, 3 = Satisfactory, 4 = Good, 5 = Excellent

11. Would you recommend the curriculum to other teachers? Why or why not?(Required)

12. Please include any additional comments in the space below. Thank you!(Required)

***We are asking each OERB funded field trip to take a picture with a branded sign provided by the museum. Please make sure your students have a signed photo release form on file with you and/or your school and email the pictures to teachers@oerb.com. We would love to share how much fun you're having on your OERB sponsored field trip!

Important Field Trip Information

Teachers must complete teaching the OERB curriculum before turning in your field trip and curriculum evaluation form.

Your field trip will only be approved for the closest, age-appropriate museum. If you are not planning to attend that museum, you must have pre-approval from the OERB before sending in this form.

You will only be contacted if there is a problem with your field trip form. If you haven't been contacted after two weeks of submission, you may contact the museum to schedule your visit.

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Field Trip Form and Curriculum Evaluation

Field Trip Information

OERB Waiver of Liability

Curriculum Evaluation

Important Field Trip Information

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Field Trip Form and
Curriculum Evaluation