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:
Number of People Traveling:
*Waivers MUST be submitted prior to trip*
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: ____________________________________________________________________________
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