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Sponsoring Student Organization
(no abbreviations please)

Organization faculty/staff advisor

Purpose of the trip:

Trip Information

Estimated # of Trip Participants
Departure Date
Departure Time
Return Date
Return Time

Trip Destination and Lodging

Trip Destination - City, State
Lodging - i.e. Hotel Name (if not staying overnight, please write "not applicable" for the next 3 questions
Lodging - City, State
Lodging - Phone #

Where can you be reached in case of an emergency?

Contact Person 1 - Name
Contact Person 1 - Phone #
Contact Person 2 - Name
Contact Person 2 - Phone #

Is an adviser going with you on the trip?

Yes
No

What kind of transportation are you using?

(Concordia College discourages the use of personal vehicles and shall not insure or accept liability for any damage, loss, or injury resulting from the use of a student participant’s vehicle).

	College Vehicle(s)		Bus
	Personal Vehicle(s)		Other