Frequent International Traveler Form

FREQUENT INTERNATIONAL TRAVELER FORM

Before completing this form, ensure a pre-approved International Travel Authorization (ITA) form is on file with the Risk Management Office. This form shall be used for pre-approved international travelers for repeated trips to the same location during the same calendar year. This form should be completed and submitted at least 7 days prior to trip departure.

Note - This form may not be used if the original ITA was a Level 3 or 4 destination. A new ITA form may be requested if there are any changes to original pre-approved travel. Examples of changes can include: country advisory level change, region/country change, purpose for travel etc.

Name*

First Name

Last Name

Email*

Departure Date*

:

Return Date*

:

Region and Country Traveling To:*

Country Advisory Level*

1 2 3 4

Please visit the Department of State website to find the current advisory level. If level has changed to 3 or 4, a new ITA will need to be completed.

Has international contact information changed from original ITA?*

Yes No

If yes, please provide updated contact information.

Has lodging information changed from original ITA?*

Yes No

If yes, please provide updated lodging information.

Provide Flight Itinerary.*

Are there any other changes from original ITA?*

Are there any other changes from original ITA?
	Yes	No
Purpose of Trip	Are there any other changes from original ITA?: Purpose of Trip (Yes)	Purpose of Trip (No)
Accompanied by Students	Accompanied by Students (Yes)	Accompanied by Students (No)
Taking NSHE Owned Equipment	Taking NSHE Owned Equipment (Yes)	Taking NSHE Owned Equipment (No)
Funding for Trip	Funding for Trip (Yes)	Funding for Trip (No)

If yes to any, please provide further information.*