Clery Post-Travel Form Student Overnight Travel to Off-Campus Locations Please submit this form within 10 days post-travel. Do NOT enter student names, phone numbers, or other student information on this form. To prevent duplicate entries, this form should be completed by the LMC employee who initiated the travel and not by students. Enter one submission per location, NOT one submission per student. If you have any questions, or submit any errors, please email ASPQ: ASPQ@lakemichigancollege.edu Clery Overnight Travel FAQS Question Title * 1. DATE OF FORM SUBMISSION: Today's date: Date Question Title * 2. FACULTY/STAFF CONTACT INFORMATION: Faculty/Staff Name: (This is the name of the person submitting this form. Student name/information should not be submitted) Department: Faculty/Staff Email: (Must be @lakemichigancollege.edu) Question Title * 3. List the Name(s) & email(s) of the trained CSA(s) who attended the travel: Question Title * 4. DATES/TIMES OF TRAVEL: Departure date/time: Date Time AM/PM - AM PM Return date/time: Date Time AM/PM - AM PM Question Title * 5. Lodging Name/Location (e.g. Holiday Inn & Suites, Benton Harbor, MI etc.): Question Title * 6. Enter all room numbers associated with your lodging reservation (e.g. 102, 110, 207, etc.): Question Title * 7. Were you required to pay for parking during your stay? Yes No Question Title * 8. Did any incidents occur during this travel? Yes No If YES, please provide your contact information (Name, Email, and Phone Number) and a staff member from ASPQ will contact you regarding next steps. SUBMIT FORM
