Louisiana Tech University: Request for Approval Form for Conducting A Study Tour Program 
(To be reviewed by)

The University Tour Committee__________ (or)
The College Review Tour Committee______
Academic School Year _____________________
 

Please answer the following questions. If any information offered below is only an estimate or approximation, please identify it as such. If additional space is needed to explain an item, continue it on an attached sheet; or contact the University Tour Committee chair to receive a downloadable application form that can be modified to provide the needed room.

1. Name of study tour program (identify any academic course number associated with the tour and credit hours to be earned)
 
 

2. Sponsoring agencies (unit, college, or other administrative unit)
 
 

3. Faculty/staff person in charge and accompanying students on study tour
 
 

4. Other faculty/staff accompanying and having responsibility for assisting with the study tour
 
 

5. Number of persons making trip [identify by (a) students, (b) faculty, (c) staff, (e) others. Provide explanation for any persons in category 'e' 
 
 

6. Destination (if more than one city/country, list multiple locations in order of study tour itinerary)
 
 

7. Study tour travel dates from______________________ to________________________
 

8. Type(s) of transportation (list types of transportation used during trip, including any transportation students will be authorized to use at the study tour site)
 
 

9. Purpose of study tour program
 
 

10. Statement of educational value of study tour program
 
 

11. Briefly describe structure of the study tour program 
 
 

12. Special activities to be accomplished on study tour
 
 

13. Type of medical insurance (e.g. SGA and/or personal)
 
 

14. Total cost of study tour program for each participant (denote what activities are included in total costs, e.g. airfare, hotel, airport pickup, number of meals, tours, subway/bus passes etc.)
 
 

15. Is each student expected to fund his/her total cost for the study tour (if not, explain financing) 
 
 
 

16. Indicate how faculty/staff salaries and expenses for the study tour will be financed
 
 
 

17. Is travel program arranged in whole, or in part, by a travel agency? If 'yes,' identify the agency.
 
 
 

18. Are services bid or is service a contractual agreement? If contractual, provide specifics. 
 
 

_______________________________________________                 _____________________
    Signature of faculty/staff person in charge

_______________________________________________                 _____________________
    Signature of unit head

_______________________________________________                 _____________________
    Signature of the Dean of the College                                                         Date
 
 

Recommendation of University Study Tour Committee, or the College Study Tour Committee (identify which) to the Vice President for Academic Affairs
 
 
 

Form approved 10 October 2001