Faculty/Researcher/Administrator International Travel Pre-Departure Attestation

Please complete the information requested below.
First name: *


Last name: *


UNI: *


Mobile phone while traveling: *


Role at the Law School: *


List the destination(s) included in this Columbia-related international travel itinerary. *


Approximate start date of travel: *


Approximate end date of travel: *


Travel Risk Assessments
What is your itinerary's highest risk rating on the ISOS Travel Security page? *

Visit the ISOS Travel Security webpage to determine your itinerary's risk rating.



Is your itinerary listed on the Countries Subject to CU Travel Advisories webpage as subject to an evacuation status of "Stand-by" or higher?

Visit the Countries Subject to CU Travel Advisories webpage to determine if your itinerary is subject to an ISOS Evacuation Status of "Stand-by" or higher.



Is your itinerary listed on the Countries Subject to CU Travel Advisories webpage as subject to Comprehensive U.S. Sanctions, or otherwise subject to a Columbia University Travel Advisory?

Visit the Countries Subject to CU Travel Advisories webpage to determine if your itinerary is subject to Comprehensive U.S. Sanctions, or otherwise subject to a Columbia University Travel Advisory.



Group Travel (please answer N/A if not applicable)
What is the name of this group? *


Who is the group leader? *


If you are the organizer/leader, are you traveling with the group? *


If you are the organizer/leader, who are the group members? *


If you are traveling, whom do you authorize Columbia University to contact in case of emergency?
Name: *


Relationship to you: *


Phone: *


Email: *


May a senior administrator contact you with regard to promoting the Law School's programs among local audiences during your overseas travel? *


Attestation
I am organizing, leading and/or traveling on the Columbia-related international travel summarized above.

I confirm that, prior to the departure date, I will comply (and, if organizing and/or leading a group, ensure that group members comply) with all of the applicable requirements listed on the International Travel Pre-Departure Requirements website. *
Signature


Dated: *