International Travel Registry
As soon as you are approved or have been enrolled into a travel program, you should complete this registration.

The purpose of this registration is to inform the College of your intended travel outside of the US and to deliver Travel Accident and Sickness Insurance and Emergency Assistance information to you.

Every Ivy Tech approved participant will be insured under the College's International Travel Accident and Sickness Insurance policy. This insurance provides coverage for medical evacuation, repatriation of remains, accidental death & dismemberment, political & natural disaster evacuation. It also offers 24/7 emergency assistance services. The fee, $25 for students and $50 for guests, will be billed by the business office and cannot be waived.

The College's travel accident policy begins on the start of the trip and ends on the earlier of the date of your personal deviation or the scheduled trip return date. You may want to purchase coverage for the remainder of your trip that is not associated with the College program.


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Email *
Your home campus *
Site Name (if applicable)
Program Leader Name *
Primary Destination *
If you are traveling to additional countries on your trip, please list them here.
Departure Date *
MM
/
DD
/
YYYY
Return Date *
MM
/
DD
/
YYYY
Purpose of the trip *
Please select what type of traveler you are *
First Name *
Last Name *
C# (enter "n/a" if not applicable) *
Home Address (Street, City, State, Zip Code) *
Mobile Phone *
Emergency Contact Name *
Emergency Contact Phone Number *
A copy of your responses will be emailed to the address you provided.
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