Travel Plans
This form is to be completed when someone is planning to travel outside of Illinois during the Fall 2021 semester while COVID-19 is still a health risk. Please fill out the information below so that we can ensure the 10 days self isolation following return from any trip outside of Illinois has been completed. A negative COVID-19 test result could expedite the stay in isolation and return to normal activities at Darul Qasim.
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Traveler's Name *
Phone Number *
Email *
Travel Begin Date *
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Return Date *
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Destination
I agree to self isolate for 14 days after arriving in Illinois or get a COVID-19 test upon arrival. When my 14 days of self isolation are over, or I receive a negative COVID test result, I may resume all activities at Darul Qasim. I understand that I will need to provide a note from the doctor if returning to Darul Qasim prior to the 14 day limit. I will inform Darul Qasim as soon as possible if my travel plans change. I will continue to conduct Darul Qasim lectures via online teaching/learning if I am well enough to do so. *
Required
Signature *
Type your full name to serve as signature
Date *
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Submit
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This form was created inside of Darul Qasim.