COVID-19 Travel Disclosure Form
If you have traveled or planning to travel, please answer the following questions.
All responses will remain confidential and will only be visible to College Administration.
Expect communication from Dr. Alethea Stovall or Sheri Paneitz.
Student Name *
Your answer
Student Email *
Your answer
Academic Program *
Your answer
Please list all the places you traveled to, including flights, cruises, country, state and city *
Your answer
Start date of travel *
MM
/
DD
/
YYYY
End date of travel *
MM
/
DD
/
YYYY
Submit
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