Viterbo University - The University of Opportunity: Hope and Help

Travel Request Form for Student Organizations & Sport Clubs

This travel form must be submitted at least 2 weeks in advance of the proposed date(s) of student organization or sport club travel. Any travel done by an organization or club, regardless of location and mode of transportation, needs to be approved by the director of campus activities or the director of recreational sports.

Contact

Today's Date:
 

Name of student completing this form:
 

Contact Phone Number:                   

Contact Email Address:
 

Travel Request Form

Student organization requesting travel:
 


 

Date(s) of travel - Departure Date  [None] Select a Date Delete the Date
 

                          Return Date  [None] Select a Date Delete the Date
 

Time leaving Viterbo:  


Time returning to Viterbo:
 

Will this event occur on other dates? If so, please list all the other dates that this event will occur.
 

Destination:
 

Reason of travel:  
 

Number of students attending:  

 

Name of trip leader(s):
 


 

In case of an emergency, how may the club be contacted? Please provide name and phone number.
 


Mode of transportation: 
 For information about Viterbo's fleet vehicles, go to: http://www.viterbo.edu/physplant.aspx?id=48736.
 

Please specify the name of the driver(s) if the mode of transportation is a personal vehicle, rented vehicle, or Viterbo fleet vehicle:
 


 

Will this be an overnight trip?

                         

Overnight Trips: Please provide information on overnight accommodations, including hotel name and phone numbers.
 

Overnight Trips: Please explain your itinerary for your day(s). Include what you might do during any free time.

 

Explanation and cost to participants:
 

Explanation and cost to organization's budget:
 

Additional cost:
 

Description of any significant concerns related to the travel.

 

The director of campus activities or the director of recreational sports will respond to your travel request by email or phone within 48 hours of submission. In that response, she will request the following forms, if needed:

  1. Liability Form
     
  2. Medical Form 
  3. Travel Roster
     

The forms will need to be returned to the appropriate office within 3 days of the trip. The appropriate office will then ensure that copies of these forms are delivered to the office of campus safety within 48 hours of departure. One set of copies will be included in your travel packet. You can find these forms at www.viterbo.edu/clubforms or at www.viterbo.edu/sportclubsforms.  

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