Confirmation of Off-Campus Domestic/International Student Trip/Academic Space Use

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Pursuant to the Clery Act, Rowan University is required to disclose on an annual basis certain reported crime statistics that occur during University-sponsored/arranged domestic and international student trips and off-campus space usage. Information on qualifying student trips and off-campus space usage is needed by the Clery Compliance Office for follow-up with the local law enforcement agency associated with the trip/space usage location. The Clery Compliance Office will send a request to the appropriate law enforcement agency to determine if any Clery Act qualifying crimes were reported during the student trip/space usage time frame.

To comply with the law, this form must be completed for any University-sponsored student travel off-campus that involves any of the following:

Lodging for two or more nights
Lodging for only one night if there is repeated use by our students (i.e., Rowan sponsors students on an overnight trip every year and students stay in the same hotel each year,)
Rental of a room or facility (excluding lodging) for student use for any length of time.
A written agreement of any type for use of space by students.

Key considerations regarding trips off-campus:

Day/Field trips (with no overnight stay) do not need to be reported.
If the University is involved in coordinating or funding (fully, partially or reimbursement), it is considered a University-sponsored trip.
If the host institution makes all of the housing arrangements for our visiting students? (Please explain details of the arrangements in space provided on this reporting form)
University personnel who either assist in the coordination or participate in the University-sponsored trip (both domestic and international) are considered a “Campus Security Authority" (CSA) under the law, and are obligated to report crimes to the University that are reported directly to them by any trip attendees.

Please answer every question, if unknown please enter "N/A" or "Unknown." This form does not need to be completed for each student participating in the trip but is required for each different lodging location.

Direct any questions to cleryact@rowan.edu or 856-256-4562.

Email *

Starting Date of Travel *

YYYY

Ending Date of Travel *

YYYY

Department/Group Sponsoring Trip (e.g., Athletics Dept., Student Life, etc.)*

Is this a Rowan University sponsored trip (i.e., University is involved in coordinating or funding (fully, partially or reimbursement)?*
*

Yes

Name of Group/Organization/ Team, etc. going on trip ( e.g., SGA, Football, etc): *

Rowan trip contact/coordinator (Considered a Campus Security Authority or CSA for the trip): *

CSA's Office Address : *

CSA's Office Telephone Number: *

CSA's Cell Phone Number: *

CSA's Email Address: *

The Clery Act requires the trip CSA to report crimes. Has the CSA reviewed the University CSA training within the past 12 months? *

Yes

Name of lodging location (i.e., hotel/site): *

Lodging address (City, State, Zip Code, Country): *

Accommodations Information ( Floor, Rooms, Building, etc.) *

Has your Department/Group used this location before? *

Yes

Name and Title Contact Information for a Representative at the Location: *

Telephone and Email for the Representative at the Location: *

Is there a written agreement (rental contract) with this space/site? *

Yes

Did the host institution make housing arrangements for visiting student? (no Rowan involvement) *

Yes

If so, explain details (i.e., identify person, department, contact information at the host institution): *

Any other pertinent information that should be noted: *

A copy of your responses will be emailed to the address you provided.

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