Proof of Insurance Request Form

Proof of Insurance Request Form

University ID*

First Name*

Last Name*

Email address*

Please enter your @iastate.edu email address below.

How are you associated with Iowa State University?*

Faculty

Staff

Student

To which country or countries will you be traveling?*

Select

Do you need a proof of insurance letter in another language in addition to English?*

If so, please indicate the language below. If not, please select No.

Note: Travel to Spain or Costa Rica requires a Spanish language letter.

Select or enter value

On what date will you arrive at your intl destination?*

Please put a date no more than 14 days prior to the start of your study abroad program or your official ISU travel.

On what date will you return from your intl destination?*

Please enter below your last date in the host country. The date may not be more than 14 days after the end of your study abroad program or your official ISU travel.

Send me a copy of my responses

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