Download the University Faculty and Staff Acknowledgement of International Travel Risks and Responsibilities. Read the Document Information and Instructions cover page carefully, making sure to complete the word-fillable fields.

Fill in the following fields in the Demographic Area:

• Your name (type or print clearly)
• Your date of birth
• Your University of Minnesota ID
• Your University of Minnesota email address
• Your emergency contact name and phone number

Fill in the following fields in the first paragraph:

• The Countries you will be visiting
• Your approximate dates of travel

Initial each page of the acknowledgement.

Fill in the following fields in the Signature Block:

• Your signature
• Your name (type or print clearly)
• The date you signed the form

If you do not fill in the appropriate information on the Faculty and Staff Acknowledgement, you will be required to resubmit it.

Please take note that by signing this acknowledgement, you indicate that you have read and accepted the responsibilities mentioned in the University Faculty and Staff Acknowledgement of International Travel Risks and Responsibilities.

The learning abroad activity in which you plan to participate is subject to the University of Minnesota Policy on Suspending Education Abroad Opportunities due to Health and Safety Risks.

 

Last modified on August 14, 2009