Group Travel Information Form

Thank you for providing an international experience for Berry College students!

Please complete the following information:

 

Name of group:  
Account number to charge insurance (indicate if OT):  
Dates of program (including travel days):    
Program site (list all countries that apply):    
Flight Information: (airlines, flight numbers, times and dates of all air travel)      
Your name:  
Title:  
Employee number:  

 

Please provide an emergency contact we can reach if necessary on your behalf:

 

Name:  
Relationship to you:    
Street Address:    
Phone (day):  
Phone (night):  
Phone (cell):  
Email:  

 

Please provide contact information for all venues/hotels where the group is staying:

 

Name of First Venue:
Physical Address:      
Phone:
Email:
Dates:  

  

Name of Second Venue:
Physical Address:     
Phone:
Email:
Dates:  

 

Name of Third Venue:
Physical Address:    
Phone:
Email:
Dates:  

 

Name of Fourth Venue:
Physical Address:  
Phone:
Email:
Dates:  

 

 

 

Name of Fifth Venue:
Physical Address:  
Phone:
Email:
Dates:  

 

Please supply a telephone number where you can be reached out of the country:

Please list the first and last names of all students and graduate assistants traveling with the group:

 

Please list the names of anyone else accompanying the group and their relationship to the group.

If any of these individuals are not Berry College employees, they will need to sign a visitors waiver, available on the IP website