APPROVED
International Reporting Registration

Your Info

First Name: *

Last Name: *

Columbia E-mail: *

Alternate E-mail: *

Mobile Phone: *

Twitter Handle

Instagram

What is the best way to reach you while you are traveling? *

If other, please describe:

Trip & Project/Thesis Info

Class (Covering Religion; Master's Project, etc.) *

Prof/Adviser: *

Prof/Advisor Email *

Prof/Adviser Mobile: *

Country to which you are traveling: *

2nd country to which you are traveling:

Risk Level (See Travel Security Online for answer) *

Travel Start Date * +

Travel End Date: * +

Please provide a detailed description of your reporting and travel plans. *

For projects/theses, how often will you be checking in with your adviser while traveling? *

Travel Check List:

Verified visa requirements for my destination country. *

Confirmed adequate health insurance coverage.
Students on international Columbia Travel must have a health insurance policy that provides for routine as well as emergency care. Note: Students covered by the Columbia University Student Health Insurance Plan have coverage in many, but not all, countries worldwide. For more information, Columbia University students should visit http://health.columbia.edu/travel-medicine *

Visited a travel health clinic or physician to assure adequate immunizations. *

Submitted an itinerary review for countries (or areas within them) having a risk rating of medium or higher. *

What is the location, address and phone for the nearest Embassy (for your home country) during your trip? Write NA if going to your home country. *

REQUIRED! All those traveling outside of the country must register their travel itinerary, personal contact information and emergency contacts using the International SOS MyTrips travel registry. You must register using your Columbia University email. Those who do not register are ineligible to submit expense receipts and will be subject to disciplinary action for non-compliance with the university's travel policy.
*

International Students: Verified with the ISSO that the travel meets the terms of my student visa. *

Checked http://www.state.gov/countries/ for travel advisories for your destination country. *

Emergency Info:

Emergency Contact 1: *

Relationship to you: *

Emergency Contact Phone: *

Emergency Contact E-mail: *

Emergency Contact 2: *

Relationship to you: *

Emergency Contact Phone: *

Emergency Contact E-mail: *

Do your emergency contacts have contact information for Dean Huff? [mgh2@columbia.edu; 917-834-2571] *

PLEASE NOTE:

* Those traveling to medium and higher risk areas should consider reaching out to the relevant Regional Director at CPJ for a consultation when planning your trip.

* Please keep in ming that, in some areas, it’s a good idea not to give away information on you location on Facebook, Twitter, or other social media.

APPROVED International Reporting Registration

Your Info

Trip & Project/Thesis Info

Travel Check List:

Emergency Info:

APPROVED
International Reporting Registration