International Travel Registration Form

International Travel Registration Form

Refer to the UAS International Travel Guidelines on our website. The Guidelines provide important safety,emergency contact, insurance, and other information for those traveling internationally on UAS business. This information may be used to assist us in contacting you and/or your designated contact in the event of an emergency.

Name of Employee Traveling*

Department/Division*

Direct Supervisor*

List Dates of Travel From (Departure) and To (Return)

Dates of Travel From*

Dates of Travel To*

Destination(s)*

Where will you be staying during your travel?*

Purpose of/Reason for Travel*

THE FOLLOWING INFORMATION MUST BE PROVIDED:

Emergency Contact(s) in the country that you will be visiting and State-side contact(s).

Visiting Country Emergency Contact Name*

Visiting Country Emergency Contact Mobile*

Visiting Country Emergency Contact Landline

Visiting Country Emergency Contact Name #2

Visiting Country Emergency Contact Mobile #2

Visiting Country Emergency Contact Landline #2

State-Side Emergency Contact Name*

State-Side Emergency Contact Mobile*

State-Side Emergency Contact Landline

State-Side Emergency Contact Name #2

State-Side Emergency Contact Mobile #2

State-Side Emergency Contact Landline #2

NOTE: IF YOU ARE TRAVELING TO AN AREA UNDER U.S. STATE DEPARTMENT TRAVEL WARNING, MONITOR THE SAFETY OF THE SITUATION CAREFULLY.

By submitting this form you are certifying this travel has been approved by your supervisor and the Chancellor, in writing, per Board Rule 413. If you have any questions about this submission, please contact Jay Trimm, jtrimm@uasystem.edu or Kaci Blue, kblue@uasystem.edu in the Office for Risk and Compliance.

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