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Student Organization Travel Registration Form

Every student organization who wishes to hold a program off campus must submit the following travel release forms at least three weeks before the scheduled event. Below is a check list of basic information that you will need to ensure that this form can be filled out properly.

Date, time, location of event and distance from WPI
Primary contact information
Contact information for Faculty/Staff member advising the trip
Travel plans (itinerary, transportation, airline, hotel information)
List of participants (names and e-mail addresses)

* Name of Event/Trip: * Location: * Location Distance from WPI in miles: * Date of Departure: * Time of Departure: * Date of Return: * Time of Return:

Note: please be sure to denote AM/PM when filling the Time of Departure and Return fields

* Sponsoring Organization: * Organization President: * E-mail: * Phone number:

Primary Contact for trip:

* Name: * Position: * E-mail: * Phone number:

Faculty Advisor:

Will he or she attend the trip: Yes No

Name: E-mail:

Note: An advisor or staff member is required to attend all trips that are outside a 120 mile radius of Worcester Polytechnic Institute and/or extend overnight.

Staff member attending trip:

Name: E-mail:

III. Trip Information

What is the purpose for this event? Provide a detailed itinerary. What is the cost of this trip and how do you plan you pay it? How does this event connect with the organizational mission?

VI. Travel Information

Participants will be: WPI Only WPI and Non-WPI

Please list all participants in the field below including their name and e-mail address. Travel release forms for every participant are required to be submitted to the Student Activities Office at least three days before the scheduled event.

Participants:

Transportation

Please fill out the information responding to the modes of transportation you will use. If there is more than one driver involved, please add this information into the detailed itinerary.

Personal Auto

Name of Driver(s): Driver(s) cell phone:

Rented Car/Van

Name of Driver(s): Driver(s) cell phone:

Coach Bus

Start Date: End Date: Company Name: Phone Number: Website:

School Bus

Start Date: End Date: Company Name: Phone Number: Website:

Accommodations

Accommodations: Yes No

If there is more than one type of lodging being used during the program, please include information in the detailed itinerary.

If Yes:

Confirmation Number (if applicable): Check In Date: Check Out Date: Location Address: Phone Number: Website:

Flight Information

Flight Information: Yes No

If yes, provide the following information. If different flights are necessary, please include additional information in the detailed itinerary

Outbound

Airline: Flight Number: Departure Airport: Date: Time: Arrival Airport Date: Time:

Return

Airline: Flight Number: Departure Airport: Date:

V. Terms and Conditions Agreement

* Must check to submit form: Agree

Name: Date:

The Office of Student Activities will review your registration form upon submission and will contact you regarding the status of your event.

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