Student Travel Form
Sponsoring Club/Organization:
Club President: Phone: Email:
Sponsor: Phone: Email:
Function/Purpose of Trip:
Dates of Travel: Number of Students: Destination:
Amount Requested: Amount Approved:
Mode of Transportation (Please provide unit cost, number of units, and total estimated cost.)
Rental car: _
Plane:____ _
College Van
Lodging:
Meals:
Registration Fees:
Name:
Last 4 of B#:
Date of Birth:
Phone Number:
(Attach additional sheet if necessary)
___________________________________________________________ ______________
Club Sponsor Date
___________________________________________________________ ______________
Student Government President Date
___________________________________________________________ ______________
Student Life Coordinator Date
___________________________________________________________ ______________
Campus Associate Provost Date
___________________________________________________________ ______________
Campus Provost Date
___________________________________________________________ ______________
Vice President, Operations Date
___________________________________________________________ ______________
Vice President, Academic Affairs/CLO Date
SC-195 R121416