TRAVEL REQUEST

OVERNIGHT TRAVEL REQUEST FORM

Please note, DAC approval does not include DCS approval. You must receive separate approval from your probation officer and pick up your travel permit from them, if needed.

This form MUST be filled out in full. Incomplete requests will not be considered.

OVERNIGHT TRAVEL REQUEST FORM

* Indicates required field

Participant Name *

First

Last

Date(s) of travel *

Address where I will be staying *

Line 1

Line 2

City

State

Zip Code

Country

Persons who will be present with me on my trip *

All DAC fees have been paid to date *

YES NO

Participant has had no positive/dilute screens in 120 days *

YES NO

Date of last positive *

Participant will test both before and after travel at their own expense ($35/test). Testing fees will be paid prior to travel. The before travel test will not count as a travel day. Return test must be taken on or before day five (5). Pre-travel test on Friday requires post-travel test no later than Wednesday before close of lab.

Participant will test on: *

Submit