Club Travel Request Form:

Club requesting travel:

Leave date and leave time:

Return date and return time:

If overnight, what accommodations have been made?:

City and State of Destination/Event Name:

Anticipated number of students traveling and competing*:

*Waiver required

Mode of travel:

Name of faculty/staff chaperone (only if more than 100 miles one way)*:

*See requirements

Name of driver(s):

Name of requester:

E-mail of requester:

Cell phone of requester:



Kim Kochin
Student Activities Club Sport Adviser
Phone: (315) 781-3513


Preparing Students to Lead Lives of Consequence.