Department ofCampus Safety

Student Trip Planning Form - for trips of 24 hours or more.

Please click here if your trip will be LESS than 24 hours.


Name of person or persons traveling:

Name of trip planner:

Drivers and Trip leaders (1 each per vehicle):

Contact Information for trip planner:
Office phone:
Home phone:

Address of destination or destinations, if more than one:

Approximate mileage from campus to final destination:

Estimated driving time and planned breaks:

Purpose of trip:

Date and time of departure from campus:

Date and time returning to campus:

Vehicle type requested (van/size, full, mid, compact car):

Driver License Numbers (required for each driver):

I have read and am fully informed about the Vehicle and Golf Cart Safety Policies and Procedures:    Yes   No

Student or student groups must obtain a signature from the advisor or coach before travel willl be authorized.  Please ask advisor/coach to review and sign this request.

By signing below, I acknowledged that I have reviewed the Vehicle and Golf Cart Safety Policies and Procedures with each trip leader and driver.

Advisor/Coach Signature:   ___________________________________

Date:   ______________      Email and phone:   ___________________________________

Return completed, signed from to: Campus Safety, Harstad.