Please use this form to request to take SNC students on an off-campus trip. This form must be submitted 4 weeks prior to trip departure date. Your Pre-Trip Proposal will be emailed to you upon submitting this form. Print a copy of the proposal to bring into the field. Your listed supervisor or Will Hoida, Dean of Students will contact you if there is an issue. Trip/Course Name*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Start Time : HH MM AM PM End Time : HH MM AM PM Number of ParticipantsPre-Trip Meeting Date* Date Format: MM slash DD slash YYYY Destination(s)*Trip/Course DescriptionTrip Leader Name*Email* Cell Phone*Add Additional Trip LeaderYesNoTrip Leader Name, Email, and Cell PhoneAdd Additional Trip LeaderYesNoTrip Leader Name, Email, and Cell PhoneApproving Advisor, Chair, or Supervisor Name*Approving Advisor, Chair, or Supervisor Email* Additional Email to receive this proposal Pre-RequisitesIdentify skills or previous courses participants need to participate.Identify desired outcomes for the tripWhy do you need to take students off campus?How will you travel to/from the off-campus site?The university currently has two vehicles that can be requested for official SNU outings on a first come/first served basis. Please check Van Request if you would like us to check van availability for your trip.Van Request Yes, I would like to use a campus van for transportation if possible. Trip DetailsTrip Classification*Urban (within minutes of advanced medical care; trip leader trained in first aid/CPR)Front-Country (within an hour of advanced medical care; trip leader trained in wilderness first aid/CPR)Back-Country (more than one hour to advanced medical care; trip leader trained in wilderness first response/CPR)Accommodations during your tripCampground, hotels, etc.; include names, locations & contact info.Please describe your plan for trip mealsClosest/Local Medical FacilityInclude name, location & contact info.Local Law EnforcementInclude name, location & contact info.Itinerary Include detailed travel, timing, desired outcomes, and site management plan. Attach lesson plans when attaining approval.Lesson Plan UploadAccepted file types: doc, docx, pdf, txt, rtf.Risks & HazardsList specific risks & hazards associated with the outing and/or site.Risk & Hazard MitigationList the specific precautions, actions, and equipment used to minimize risk.Roster Upload: student names and cell numbers, emergency contact names and cell numbersAccepted file types: doc, docx, pdf, txt, rtf.Enter a student roster if you have one at this time. If any changes occur, notify your advisor/supervisor/chair by email ASAP. If a roster is not uploaded now, it is the trip leaders’ responsibility to email the advisor/supervisor/chair with a complete roster prior to the trip departure.