Travel Check-Out Form

The purpose of this form is to ensure that, in the event of an emergency, we are able to locate all BU students and confirm their safety.

If you are traveling outside of Los Angeles overnight you must complete this form and submit it prior to your departure.

Itinerary:
Name of Student:*
First Last
Destination:*

Please list the places you are going
Departure Date:*
MM slash DD slash YYYY

Please enter the date in the following format: mm/dd/yyyy.
Return Date:*
MM slash DD slash YYYY

Please enter the date in the following format: mm/dd/yyyy.
Mode of Transportation:
- Auto
- Airplane
- Train
Car Info:

Make/Model
Year
License plate #
Airline Details:

Departing Airline
Flight Numbers
Train Info:

Train #
Destination Information:
Location:
Street Address City State / Province / Region ZIP / Postal Code Country
Is anyone traveling with you?
- Yes
- No
Name of Companion Traveler #1
First Last
Phone Number of Companion Traveler #1
Name of Companion Traveler #2
First Last
Phone Number of Companion Traveler #2
Captcha

Travel Check-Out Form

Travel Check-Out Form

Itinerary:

Destination Information: