/ Student Engagement/ Travel Request and Itinerary

Travel Request and Itinerary

All student organizations must submit the following information no less than two weeks (14 days) before they intend to travel.

Transportation Rules
1) No driving between Midnight and 5am.

2) The consumption of alcohol, drug, or other intoxicating substance is prohibited while traveling and within one full day (24 hours) of travel.

3) Seat belts must be worn by all vehicle occupants at all times.

4) Carrying alcohol, drugs, or other intoxicating substances in opened or unopened containers is prohibited.

5) Drivers are not allowed to carry any unauthorized passengers. This includes, but is not limited to, hitchhikers, friends, family members, pets, etc).

6) The vehicle driver may not use their cell phone unless the vehicle is pulled over to a safe location and placed in park.

7) If a personal vehicle is driven, a Vehicle Owner/Driver Acceptance of Responsibility Form must be on file with Student Activities and all information is current.

8) All drivers must be cleared drivers by Facilities Services before driving. Once Driver Clearance Forms are completed, please bring them to Student Activities for approval, and submission to Facilities Services. Please note that drivers who are not cleared are not eligible for any reimbursements for mileage or gasoline.

All fields marked with asterisk (*) are required.

required date field

Today's Date*

Please enter today's date.

required text field

Full Name of Person Making Request*

Please enter your full name.

required text field

Requestor's Cell Phone Number*

Please enter your cell phone number

required e-mail address field

Requestor's L&C Email Address*

Please enter your L&C email address.

required text field

Name of Student Organization*

Please enter the name of your student organization.

required text field

Number of Student Organization Members Traveling*

Please enter the number of organization members who are traveling.

required text field

Event and Location*

Please enter the name of the event that you're traveling to and where it is located.

required date/time field

Departure Date and Time*

Please enter the date and approximate time of when you're leaving L&C.

required date/time field

Return Date and Time*

Please enter the date and approximate time of when you're returning to L&C.

required text field

EMERGENCY CONTACT: Name of Event Organizers*

Please enter the name of the organization and/or people who are organizing the event you're going to.

required text field

EMERGENCY CONTACT: Event Organizers' Phone Numer*

Please enter the phone number for an event organizer who is available 24-hours.

text field

EMERGENCY CONTACT: Event Organizers' Email Address

Please enter the email address for an event organizer who is available 24-hours.

required text field

EMERGENCY CONTACT: Nearest Hospital*

Please enter the name of the closest hospital to the event.

required textarea field

Lodging Information*

Please enter the name and address of where everyone will be staying.

textarea field

Air Travel Information (if applicable)

Please list your airline(s), flight number(s), departure time(s), and arrival time(s).

required text field

Number of Vehicles Being Used*

Please enter the number of vehicles being used for this trip.

required text field

Vehicle #1 Driver*

Please enter the name of the dirver of Vehicle #1.

required text field

Vehicle #1 Driver's Driver License Number*

Please enter the driver license number and state that it is issued from for the driver of Vehicle #1.

required text field

Vechicle #1 Driver's Cell Phone Number*

Please enter the cell phone number for the driver of Vehicle #1.

required text field

Vehicle #1 License Plate Number*

Please enter the license plate number and the state where the vehicle is registered for Vehicle #1.

required text field

Vehicle #1 Registered Owner*

Please enter the full name of the registered owner of Vehicle #1.

required text field

Vehicle #1 Registered Owner's Cell Phone Number*

Please enter the cell phone number of the registered owner of Vehicle #1.

required textarea field

Vehicle #1 Passengers*

Please enter the names and cell phone numbers for the passengers of Vehicle #1. (Vehicle passengers understand that they are passengers in a personal vehicle, not a Lewis & Clark College vehicle, or rental vehicle, that the person who is the driver of the personal vehicle is responsible for the insurance and liability of the vehicles and not the individuals in the vehicle. Passengers knowingly understand that Lewis & Clark College is NOT liable for that vehicles or any damage done to the vehicle or myself.)

text field

Vehicle #2 Driver (if applicable)

Please enter the name of the dirver of Vehicle #2.

text field

Vehicle #2 Driver's Driver License Number (if applicable)

Please enter the driver license number and state that it is issued from for the driver of Vehicle #2.

text field

Vechicle #2 Driver's Cell Phone Number (if applicable)

Please enter the cell phone number for the driver of Vehicle #2.

text field

Vehicle #2 License Plate Number (if applicable)

Please enter the license plate number and the state where the vehicle is registered for Vehicle #2.

text field

Vehicle #2 Registered Owner (if applicable)

Please enter the full name of the registered owner of Vehicle #2.

text field

Vehicle #2 Registered Owner's Cell Phone Number (if applicable)

Please enter the cell phone number of the registered owner of Vehicle #2.

textarea field

Vehicle #2 Passengers (if applicable)

Please enter the names and cell phone numbers for the passengers of Vehicle #2. (Vehicle passengers understand that they are passengers in a personal vehicle, not a Lewis & Clark College vehicle, or rental vehicle, that the person who is the driver of the personal vehicle is responsible for the insurance and liability of the vehicles and not the individuals in the vehicle. Passengers knowingly understand that Lewis & Clark College is NOT liable for that vehicles or any damage done to the vehicle or myself.)

text field

Vehicle #3 Driver (if applicable)

Please enter the name of the dirver of Vehicle #3.

text field

Vehicle #3 Driver's Driver License Number (if applicable)

Please enter the driver license number and state that it is issued from for the driver of Vehicle #3.

text field

Vechicle #3 Driver's Cell Phone Number (if applicable)

Please enter the cell phone number for the driver of Vehicle #2.

text field

Vehicle #3 License Plate Number (if applicable)

Please enter the license plate number and the state where the vehicle is registered for Vehicle #3.

text field

Vehicle #3 Registered Owner (if applicable)

Please enter the full name of the registered owner of Vehicle #3.

text field

Vehicle #3 Registered Owner's Cell Phone Number (if applicable)

Please enter the cell phone number of the registered owner of Vehicle #3.

textarea field

Vehicle #3 Passengers (if applicable)

Please enter the names and cell phone numbers for the passengers of Vehicle #3. (Vehicle passengers understand that they are passengers in a personal vehicle, not a Lewis & Clark College vehicle, or rental vehicle, that the person who is the driver of the personal vehicle is responsible for the insurance and liability of the vehicles and not the individuals in the vehicle. Passengers knowingly understand that Lewis & Clark College is NOT liable for that vehicles or any damage done to the vehicle or myself.)

required checkbox field

Electronic Signature*

I certify that I am submitting this information to the best of my knowledge and understand that I will be contacted by Student Activities to review this submission.

Link (required)