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: *


Important Information about the next question. Travel Risk Assessments
What is your itinerary's highest risk rating on the Crisis24 Horizon "Location Intelligence" webpage? *
Additional instructions for the previous question. 

If you have not already done so, create a Crisis24 Horizon account via their website.

After logging into Crisis24 Horizon, go to "Intelligence" and then "Location Intelligence" to determine the highest risk level associated with your proposed itinerary.



Is your itinerary subject ranked as a "High" or "Extreme" travel risk?
Additional instructions for the previous question. 

To determine your proposed itinerary's highest associated travel risk log into Crisis24 Horizon, go to "Intelligence" and then "Location Intelligence" to determine the highest risk level associated with your proposed itinerary.



Is your itinerary subject to CU Travel Restrictions?
Additional instructions for the previous question. 

To determine whether your itinerary is subject to CU Travel Restrictions, please look at the lists posted at https://globaltravel.columbia.edu/content/proposing-travel-andor-activities-abroad.



Important Information about the next question. 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? *


Important Information about the next question. 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? *


Important Information about the next question. 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.
*
Additional instructions for the previous question. Signature


Dated: *