Attachment I

Texas State University-San Marcos

Student Travel Form

To register a trip, please complete this form and submit it to sponsoring organization or department which recognizes the travel at least 10 working days prior to date of departure.

Please Print or Type

Sponsoring Organization:__________________________________________________

Trip Coordinator:________________________________________________________

Destination:____________________________________________________________

(If multiple destinations, please attach a trip itinerary)

Purpose of Trip:_________________________________________________________

______________________________________________________________________

______________________________________________________________________

Date and estimated time of departure from Texas State:___________________________

Date and estimated time of arrival at destination:_________________________________

Date and estimated time of return to Texas State:________________________________

Date and estimated time of departure from destination:____________________________

Transportation                      

 Airline/bus/train (carrier):________________________________________________

 By university vehicle

 By university rented vehicle

 By personal vehicle (license number)___________________ State:_______________

 Other (identify):________________________________________________________

Name of Driver(s):________________________________________________________

______________________________________________________________________

______________________________________________________________________

Lodging

Name of hotel/motel:______________________________________________________

(if multiple destinations, provide additional accommodation information)

Address:_________________________________________ Phone # ______________

Address and phone number if other than above, where trip coordinator or advisor may be reached:
______________________________________________________________________

Will your advisor or other Texas State faculty/staff member accompany you? ____________  

Please provide the following information:

Name of advisor/faculty/staff: ________________________________________________

Department: ____________________________________________________________

Campus Phone #:_________________________

Home Phone#:___________________________

Are University Resources being used to fund any portion of this trip? __________________

Please provide the names and phone numbers of 2 Texas State staff or faculty members who can serve as emergency contacts in the event someone from the advising office or department is unavailable for contact.

Name of emergency contact person:___________________________________________

Department: _____________________________________________________________

Title: ___________________________________________________________________

Contact Phone #:__________________________

Name of emergency contact person:___________________________________________

Department:_____________________________________________________________

Title: __________________________________________________________________

Contact Phone #:___________________________

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I certify that the organization I represent has agreed to sponsor this trip and will take responsibility for conducting it according to the policies governing such matters.  The sponsoring organization takes sole responsibility for all financial obligations and for the actions, activities, and products associated with this trip, unless other arrangements have been made.  In addition, I certify that I will have informed others on the trip of the university’s requirements governing student travel.

Signatures

______________________________________________________________________

Sponsoring Organization President/Representative                    

______________________________________________________________________

Address                                 Phone                     Date

______________________________________________________________________

Sponsoring Organization Advisor                                                  

______________________________________________________________________

Address                                 Phone                     Date

*Note:  This form must be submitted 10 working days prior to date of departure.  In addition to completing this Travel Form you must complete the Student Group Travel List and the Trip Release and Indemnity Form.  These forms can be obtained in the Dean of Students Office and the Office of Campus Activities and Student Organizations. 

Date Received: _________________________________        

Approval: ______________________________________

Date of Approval: ________________________________