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Clery Act Student Travel Form

This form is to be completed for any University-related overnight travel. That includes students such as athletics, academics, clubs/organizations, etc.

All fields marked with asterisk (*) are required.

required text field
header field

Travel Contact Person

required text field
required text field
required text field
required text field
required email address field
header field

Travel Dates

required date field
required date field
header field

Lodging Facility Information

paragraph field

Note: If group is staying at more than one lodging facility, please complete a separate form for EACH facility.

required text field
required text field
required text field
required textarea field
required radio button field
This trip is:*
radio button field
If trip is repeated, our group
text field