International Travel Registration for Faculty and Staff | Study Abroad

Please fill out the form below and visit SAGE’s International Travel page for more details on this process. If you are traveling to Puerto Rico, enter 0 in the required fields that do not apply to you.

Contact Information

First Name

Last Name

Alternate Email

Mobile Phone

International Mobile Phone

Campus

Department

Supervisor's Name

Supervisor's Phone Extension

Emergency Contact Information

First Emergency Contact Full Name

First Emergency Contact Relationship

First Emergency Contact Email

First Emergency Contact Phone

Second Emergency Contact Full Name

Second Emergency Contact Relationship

Second Emergency Contact Email

Second Emergency Contact Phone

Travel Information

Passport Expiration Date

Passport Requirement

I understand that I must submit a copy of my passport to the SAGE Office at least two weeks prior to departure.

Reason for travel

Destination Information

Please list every country and city that you will visit and include where you will be staying at each location.

Will you be travelling to and staying in more that one country?

Yes

Program Destination 1

Destination Country

Destination City

Destination Arrival Date

Destination Departure Date

Closest U.S. Embassy/Consulate Phone

Closest U.S. Embassy/Consulate Address

Accommodations Name

Accommodations Address

Accommodations City

Accommodations Postal Code

Accommodations Phone

Safety Information Destination 1

What is the current travel advisory level for the country you are visiting according to the U.S. Department of State?

Search current travel advisories.

Level 1 - Exercise Normal Precautions

Level 2 - Exercise Increased Caution

Level 3 - Reconsider Travel

Level 4 - Do Not Travel

Are there current travel advisories affecting the areas in which you are visiting? If yes, provide more details: open the country travel advisory and include relevant information.

Home Flight Information

Departure from Home Date

Departure from Home Airline

Departure from Home Flight Number

Return to Home Date

Return to Home Airline

Return to Home Flight Number

Medical / Trip Insurance

Valencia requires medical/trip insurance for all individuals traveling on college business. The SAGE Office only pays for insurance for previously approved faculty/staff exchange programs.

For all other circumstances, please provide an index number to charge OR you must pay out-of-pocket at the Business Office. Contact the SAGE Office once your payment has been made.

Please note, if you are paying for insurance out of college accounts, you may be required to show the SAGE Office proof of available funds before any transactions are made on your behalf.
*By submitting this form, you are agreeing to the following:

I understand that I must submit payment for insurance at least two weeks prior to departure.

I understand that I may be required to show proof of available funds (you may be asked to provide a screenshot of your budget).

I will pay out-of-pocket at the Business Office.

I have an index to charge (if yes, enter number below).

Index Number

Classes (faculty only)

Will participation in this conference require you to miss any scheduled classes?

Yes

If yes, have you received dean approval?

Yes

Safety

If any of your destinations have a Department of State Level 3 (Reconsider Travel) or Level 4 (Do Not Travel) Advisory, does your supervisor approve your travel?

Yes

What will be the best way to reach you while overseas?