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Student Travel Fund Request for Support

Sponsor’s Information:
First Name:
Last Name:
Department:
Extension:
E-mail:
Trip Name (for funding use):
Budget Line (where to transfer funds):
Student Contact:
 
Trip Details:
Number of Students Attending:
Dates of Travel:
Destination:
Estimated Overall Costs per person:

Itemization of costs:

     Lodging (hotel/housing):
     Transportation:
     Airfare, rental vehicle(s), gas
 
     Meals:
     Excluding those covered in registrations
     Registration Fees:
     Materials:

     Other Categories (please explain):
 
       

 

 
Supporting Documentation – any supporting documentation (i.e. accepted abstracts, course descriptions/syllabus, itineraries, brochures, registration forms) should be included with this request form as well as listed here:

      

 
Trip Objectives/Expected Outcomes:
 
Trip Objectives (mark all that apply & explain below):
    Educational Research/Presentation Service
       

Expected Outcomes:

      

Anticipated benefit to the Clarke community:
 
      
 
Opportunities Available for Course Credit:

Number of credit hours available:
Professor:
 
Describe how this trip will specifically serve the stated course objectives:
 
      
 
Funding Details:

Total Amount Requested:
 
      
Current sources of funding available:
 
      
Amount of funding currently available to individual or group for this activity:
 
      
 
If a similar trip was taken previously, please explain how it was paid for:
 
      
 
Service Opportunities
(to be completed only if “service” was checked as one of the trip objectives):
Nature of the service work:
 
      
Describe how the service work reflects Clarke’s mission, vision and core values:
 
      
List all prerequisites/preparation/reflection asked of the students prior to the trip:
 
      

 
Required Follow-up:
Note: All students receiving funding are asked to submit a brief synopsis upon their return that includes how the trip benefitted their Clarke experience. It is the responsibility of the chaperone and sponsoring department to ensure that this information is given to the Student Travel Committee. It will be used, with the students’ permission, for the purpose of future student travel appeal content and promotion of Clarke.

Students receiving student travel funding during the school year are also expected to share their experiences with the Clarke community within two-three weeks of returning and in September for summer time travels. Presentation styles are up to the group and can range from written accounts in campus publications and photographic displays to lectures/presentations, movies and panel discussions.

 

 

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