Student Travel Form First and Last Name * Group Name * Travel Contact Information By filling out this form, I understand that I am a Campus Security Authority (CSA) for this trip and must report to ULPD in a timely manner any crimes brought to my attention. Name (First and Last) * Title * Department * Phone Number * University Email Address * Travel Dates Check-in Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024202520262027 Check-out Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024202520262027 Lodging Facility Information Note: If your group is staying at more than one lodging facility, please complete a separate form for EACH facility. Name of Facility * Facility Address * Street Address: City: State: Zip: Parish/County: Country: Facility phone number * Specific floor(s), room number(s), or unit number(s) occupied: * This trip is: * A one-time trip Repeated each semester Repeated annualy Other Please explain. * For repeat trips, our group: * Always stays at the exact same lodging facility Uses various lodging facilities with each trip Leave this field blank
