International Travel Form for Student

INDIVIDUAL Student International Travel Form

"*" indicates required fields

  • HAVE ALL YOUR INFORMATION TOGETHER BEFORE BEGINNING THIS FORM.
  • Review the International Travel Policy.
  • All fields on this form are MANDATORY for the purposes of registering your travel with the WFU/Worldcue Traveler system.
  • This form should be completed as soon as possible prior to traveling so that we have sufficient time to register your travel and purchase international health insurance.
  • After completing this online form, submit the following forms to GPS via hardcopy to 116 Reynolda Hall or by email to gps@wfu.edu:
    1. International health insurance (GeoBlue) application
    2. Student Assumption of Risk & Release
    3. Assumption of Risk & Release – OTHER travelers, if traveling with another person (e.g. spouse or child)
    4. Student Health Questionnaire
With the submission of this form, I confirm that I have read the International Travel Policy. I understand by signing this form that Wake Forest University reserves the right to deny funds for travel outside the United States at any time prior to departure. In the event funding is approved, I understand and acknowledge that this trip is taken on my own initiative. I further understand and acknowledge that I accept full responsibility for all risks, both known and unknown to me, which may be associated with my travel and that WFU makes no representation of any kind concerning the risks presented by my travel plans. In addition, I understand that I may be required to attend a security briefing prior to my departure.
Please provide the name of your sponsoring department and the email address of your Department Chair or Scholarship Sponsor. This form will be routed for the appropriate signature.

Name of Traveler*
Unit (select one)*
MM slash DD slash YYYY
MM slash DD slash YYYY
(Ex. independent research, conference, scholarship recipient, professional development)
MM slash DD slash YYYY
MM slash DD slash YYYY
If you do not have your accommodation information at this time, “TBD” is acceptable here. Once your plans are finalized, submit AS SOON AS POSSIBLE to GPS.
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
Accepted file types: jpg, gif, png, pdf, docx, Max. file size: 32 MB.
Domestic Emergency Contact Information
Name*
Address*
This field is for validation purposes and should be left unchanged.

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