Evacuation Plan Form in PDF format
Evacuation Plan Form in MS Word format

(to be filled out by trip leader and filed with LOC Safety Officer or Appropriate Section/Division Head
or designate prior to trip departure)

Example of a completed Evacuation Plan Form

Field Trip Name          _________________________________________________

Date                           _________________________________________________

Field Trip Leader       _________________________________________________

Responsible Safety officer      Name______________________________________
                                             Phone __________________________

General Information

Stop # Evacuation Challenge   Evacuation procedures Nearest emergency medical facility Hours of operation









Last modified: May 2, 2010
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