T.C

..........................VALİLİĞİ

GEZİ PLANI

GEZİLECEK YER VE KONUSU:........................................................................................

GEZİ TARİHİ                               :........../....../...........

GEZİNİN AMAÇLARI                  :.......................................................................................

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GEZİYE KATILACAK ÖĞRENCİ SAYISI:    KIZ:             ERKEK:             TOPLAM:

GEZİYE GİDİLECEK ARACIN CİNSİ:...........................................................................

                                                    PLAKA NO:.................................................................

                                                    SÜRÜCÜ:.....................................................................

GEZİ BÖLGESİNE GİDİŞ GÜZERGAHI:.......................................................................

GEZİ İÇİN TOPLANMA YERİ VE SAATİ:...................................................................

GİDİŞ SÜRESİ(TAKRİBEN)                     :.................................

GEZİ YERİNE VARI   SAATİ                   :.................................

GEZİ YERİNDEN AYRILIŞ SAATİ         :.................................

GEZİ BİTİMİNDE DAĞILMA   

YER VE SAATİ                                        :.................................

GEZİNİN DÜZENLENMESİ UYGULANMASINDAN SORUMLU ÖĞRETMENLER:

                                                        UYGUNDUR

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                                        ................................OKULU MÜDÜRÜ