8/18
Club & Organization Travel Form
Student Activities Office Parsons Union Building Lock Haven University
2018-2019
This form must be completed and returned to the Student Activities Office TWO WEEKS prior to the departure date of the trip.
Failure to submit this form may result in disciplinary action for the club.
Club/Organization Name: ___________________________________________________________________
Trip Contact Person: ____________________________Cell Phone #: _________________________________
(This person must be present on trip)
Departure Day, Date, & Time:
Return Day, Date, & Time:
Destination:
Number of People Traveling:
*Waivers MUST be submitted prior to trip*
Purpose of Travel:
Field Trip: Name of Field Trip: ________________________________________________________
Competition: Name of Competition: ___________________________________________________
Meeting: Name of Meeting: _________________________________________________________
Community Service: Name of Community Service: _______________________________________
Conference: Name of Conference:_____________________________________________________
Other: ____________________________________________________________________________
Funding Source(s):
Budget Funding Source(s):
Budget
Special
Other ____________________________________
Roster of Trip Participants
see back of form
Detailed Itinerary
must list on back of form
Include travel dates, times, locations, relevant flight
information, car rental, car usage, schedule of activities
Transportation & Vehicle Information:
Please indicate all method(s) of travel:
Bus / Motor Coach
Airline Travel
Personal Vehicle
Rental - *If renting a vehicle, group must purchase all additional insurance coverage available as well as
present a LHU SAS, INC. Purchase Order to reserve the vehicle*
o Enterprise: _____________________________________
o Other: _________________________________________
*Additional Information Requested & Required on Back of Form Please Complete Other Side
Driver Information List all drivers for personal and/or rental vehicles. Attach Additional Sheets as Necessary
8/18
List Roster of all Trip Participants - Attach Additional Sheets as Necessary
Detailed Trip Itinerary Indicate detailed timeline of activities, including dates, times, locations and schedule of activities.
Attach Additional Sheets as Necessary