Off-Campus Student Travel Form

As part of ensuring student safety and meeting University requirements under the Clery Act, this form must be completed by the person coordinating or organizing student travel when a) a student or student group is engaged in overnight stay travel and b) the travel is sponsored by a University of La Verne student group, office or department, faculty or educational program.

Once submitted, a copy of this form will be emailed to 1) the faculty/staff responsible for travel, 2) the Dean of Students Office, 3) Campus Safety, and 4) Risk Management.   For travel sponsored by ULV Athletics, a copy of this form will also be emailed to 1) Provost Office and 2) the Athletics Compliance Officer.  Travel organizers should note:

  • All policies and processes, as listed in the Code of Student Conduct, are in effect during all University of La Verne sponsored travel.
  • Report any incidents, including accidents and health emergencies, violations of student conduct, or Clery crimes (i.e. murder, assault, arson burglary, robbery, vehicle theft, sexual assault, sexual battery, stalking, dating violence, liquor or drug law violations, weapons possession, hate crimes) to Campus Safety (909-448-4950).

Questions regarding this requirement on this form should be directed to the Dean of Students Office by calling (909) 448-4448.

Off Campus Travel Form

  • NameTitleCell Phone 
  • NameTitleCell Phone # 
  • CityStateZipStart Date (mm/dd/yy)End Date (mm/dd/yy) 
  • Name of Hotel/LocationStreet AddressCityStateZipStart Date (mm/dd/yy)End Date (mm/dd/yy) 
  • Name of DriverDriver's License #La Verne ID # 
    (enter "n/a" if not applicable)
  • Participant NameCell Phone #Name of Emergency ContactEmergency Contact Phone # 
    In leu of entering names, a document (roster) with the required information can be uploaded
  • Drop files here or