Student Travel Approval Form

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COLLEGE-SPONSORED
STUDENT TRAVEL APPROVAL FORM

Please complete this form for each College-sponsored trip such as athletic events, academic field trips, clubs/organizations excursions, etc. This form and all required attachments must be submitted at least four (4) weeks prior to the departure date. There are no exceptions to this deadline.

CHECKLIST (PLEASE ATTACH ALL DOCUMENTS IN ONE PACKET):

Completed copy of “College-Sponsored Off Campus Travel Approval Form” (this form)
Conference Brochure/Information (if applicable)
Student Club/Organization Meeting Minutes (if applicable)
Agenda/Itinerary of Trip (if applicable)

NOTE: El Camino College faculty and staff who lead a College-sponsored trip are considered Campus Security Authorities (CSA) and are also required to submit information about the names and location(s) of lodging facility and the date(s) of stay in order to assist the College in complying with the federal Clery Act prior to their departure on the trip. Furthermore, all College employees traveling with students off campus are considered Campus Security Authorities and must complete annual training prior to departure. You may contact the Clery Act Compliance Coordinator in Campus Police Department at 310-660-3100 or clery@elcamino.edu if you have any questions.

Additional Note: For Faculty/Staff submitting reimbursement for trip, please complete the District Travel Form in conjunction with this form

For more information on district-sponsored travel, please view the El Camino College Board and Administrative Policies:

Indicate type of travel:*

Student Club/Organization Excursion Instructional Field Trip Athletics Trip

Division/Club Information

Class/Department/Club Name:*

Representative Name:*

First Name

Last Name

Representative ECC Email:*

Representative Phone:

Signed Meeting Minutes*

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Your student club must approve this event before moving forward with this form. You must attach meeting minutes showing the club has voted to approve the event and must be signed by the club president and advisor.

Trip Information

Trip Name:*

Description of Trip/Plan of Student Participation:*

Please describe how this excursion or field trip is critical to the purpose and mission of your student organization or program. *

The assigned Area Vice President will review this proposal and present it to the El Camino College President’s Cabinet for approval

Date and Time of Departure from ECC:*

Return Date and Time to ECC:*

Trip Location:*

Trip Address:*

Address Line 1

Address Line 2

City

State

ZIP Code

This trip is:*

a one-time trip repeated each semester repeated annually

Other:

Lodging Facility Information

Is there an overnight stay?*

Yes No

Lodging Location:*

Is the lodging location address the same as the trip address above?*

Yes No

Lodging Location Address:*

Address Line 1

Address Line 2

City

State

ZIP Code

Check in Date and Time:*

Check Out Date and Time:*

Is there an overnight stay at another location?*

Yes No

Lodging Location:*

Lodging Location Address :*

Address Line 1

Address Line 2

City

State

ZIP Code

Check in Date and Time:*

Check Out Date and Time:*

If you have more than three overnight lodging locations, please list the lodging information in the text box below:*

Please check here to confirm itinerary for all locations, addresses, check in/check out dates and times have been submitted*

YES

Mode of Transportation

What mode of transportation will be used?*

ECC vans** Personal Vehicle Rental Vehicle Charter Bus Commercial Airline

**Students are able to transport themselves using their own personal vehicles. A student can only provide transportation for other students if they have completed the ECC Safe Driver Training.

Note: Any ECC employee or student that will be operating a vehicle that transports ECC students must complete the ECC Safe Driver Training.

Is the location/destination within 20 miles of El Camino College?*

Yes No

All trips more than 20 miles from El Camino College will be reviewed by the Vice President after submission

Total # of ECC students attending: *

Campus Security Authority (CSA) 1 Information

Please read the following statement:

As an individual who is leading this trip (ie. faculty advisor, coach, etc.), in accordance with the Clery Act, you are required to report allegations of Clery Act crimes that are made known to you in good faith in an accurate and timely manner to the El Camino College Police Department at 310-660-3100 or www.elcamino.edu/clerycsareporting. Any incidents that are criminal in nature should also be reported to the local law enforcement agency having jurisdiction over the location of occurrence.

By signing below, the attending individual must adhere to the policy statement above, El Camino College Administrative Policy 4300 and all other ECC Board Policies and Administrative Procedures.

Campus Security Authority (CSA) #1:*

First Name

Last Name

Signature to Acknowledge Statement Above*

[clear]

Use your mouse or finger to draw your signature above

Campus Security Authority #1 ECC Email:*

Campus Security Authority #1 Phone:*

Has the Campus Security Authority completed Clery Act CSA training in the current calendar year?*

Yes No

Please contact the Clery Act Compliance Coordinator at 310-660-3100 or clery@elcamino.edu as soon as possible (before your trip departs)

Do you have another CSA attending the trip?*

Yes No

Please list the NAMES and CONTACT INFORMATION of the additional Campus Security Authorities attending the trip below:*

SDO Director Review

SDO Director Decision*

Approved Denied

Administrator's reason for denying this request*

Signature*

[clear]

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Administrator Review

Name of administrator*

First Name

Last Name

Adminstrator's Decision*

Approved Denied

Administrator's reason for denying this request

Signature*

[clear]

Use your mouse or finger to draw your signature above

Vice President Student Services Review

Vice President Name*

First Name

Last Name

Vice President Decision*

Approved Denied

Vice President's reason for denying this request

Signature*

[clear]

Use your mouse or finger to draw your signature above

Vice President Academic Affairs Review

Vice President Name*

First Name

Last Name

Vice President Decision*

Approved Denied

Vice President's reason for denying this request

Signature*

[clear]

Use your mouse or finger to draw your signature above

Division/Club Information

Trip Information

Lodging Facility Information

Mode of Transportation

Campus Security Authority (CSA) 1 Information

Approving Administrator

SDO Director Review

Administrator Review

Vice President Student Services Review

Vice President Academic Affairs Review