Please print or type all responses Flight information (or attach airline itinerary) (include airline name, flight numbers and dates/times of travel) Travel Monitor Name and Affiliation with Group: Academic Department or Student Organization Name: Reason for Travel: Mode(s) of Ground Transportation Applicable Requested Accommodations Check all that apply Information (include facility name(s), address(es) and phone number(s)) UC Transportation van, bus or automobile UC Org Unit Vehicle (provide unit name) Private Automobile(s) (provide license no(s) and owner names) Chartered bus/vehicle (provide company name, address, phone Will a faculty member or advisor be accompanying the students and name of UC employee on the trip? Yes (provide name, email and phone no.) No booking reservation) Other (provide carrier contact information and name of UC employee booking reservation Travel Itinerary Submitted by: Travel is: Domestic International Travel Dates: Destination(s): Travel Print Name Monitor’s Signature/Date Submitted to: to to Campus Contact Signature/Date Print Name Authorized by: to Sponsoring Department/Organization/Date Print Name
Flight information (or attach airline itinerary) (include airline name, flight numbers and dates/times of travel) Travel Monitor Name and Affiliation with Group: Academic Department or Student Organization Name: Reason for Travel: Please print or type all responses Travel Itinerary Travel is: Domestic International Travel Dates: Destination(s): to to to Mode(s) of Ground Transportation Check all that apply Applicable Requested Information UC Transportation van, bus or automobile UC Org Unit Vehicle (provide unit name) Private Automobile(s) (provide license no(s) and owner names) Chartered bus/vehicle (provide company name, address, phone and name of UC employee booking reservation) Other (provide carrier contact information and name of UC employee booking reservation Accommodations (include facility name(s), address(es) and phone number(s)) Will a faculty member or advisor be accompanying the students on the trip? Yes (provide name, email and phone no.) No Submitted by: Travel Monitor’s Signature/Date Print Name Submitted to: Campus Contact Signature/Date Print Name Authorized by: Sponsoring Department/Organization/Date Print Name
StudentTravelGroupAuthorizationAndContact%20Form.docx