Off-Campus Trip Notification Form

All off-campus trips involving the transport of students must be documented with Century College. Please complete the following form. All fields marked with an asterisk (*) are required.

All fields marked with asterisk (*) are required.

required text field

Organizing/sponsoring department or organization*

required text field

Faculty/staff/student leader name*

required e-mail address field

Faculty/staff/student leader email*

required text field

Faculty/staff/student leader cell #*

required checkbox field

Has the faculty/staff/student leader completed the Clery Act-required Campus Security Authority (CSA) training this year?*

If no, please contact Jason Philipp at jason.philipp@century.edu and Nathan Mens at nathan.mens@century.edu. This training must be completed prior to your trip.

Yes

No - please contact Jason Philipp at jason.philipp@century.edu and Nathan Mens at nathan.mens@century.edu

required checkbox field

Is this an annual/repeated trip?*

Yes

required textarea field

Purpose of trip*

required textarea field

Trip destination (be specific)*

City, state, country

required textarea field

Participants*

Please list the names and contact numbers for each participant, as well as other pertinent information that you want to have on file.

required date field

Departure date*

required date field

Return to campus date*

text field

Hotel name

text field

Hotel address

date/time field

Hotel check in date & time

date/time field

Hotel check out date & time

textarea field

If you will be staying at more than one hotel, please add that information here:

textarea field

If there are any other details about your trip that you want to share, please add here:

Link (required)

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Off-Campus Trip Notification Form

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