Travel Notification Form
I am a *
Required
Names of those traveling (Last, First) *
Your answer
Schools: Please select all that apply. *
Required
Contact Information
Phone *
Your answer
Email
Your answer
Please identify an emergency contact (Name, Relationship, Phone)
Your answer
Travel Information
Is anyone living in your household planning to travel (or are you currently traveling) outside of the United States? *
Please list any international destinations that you are currently traveling in or plan to travel to.
Is anyone living in your household planning to travel (or are you currently traveling) domestically? *
Please list any domestic destinations that you are currently traveling in or plan to travel to.
Your answer
Please describe your travel plans. Include departure and arrival dates and any airports and locations visited (city, state, country, etc.).
Your answer
Are you aware that you must self-quarantine for 14 days prior to returning to school if you have traveled to China, Iran, Italy, South Korea, Japan or any other country or location determined to be a Level 2 or Level 3 by the CDC (https://wwwnc.cdc.gov/travel/notices)? * *
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