WCJC International Travel Information
The registration form below is for WCJC students, faculty and staff who are:
Returning from a CDC Level 2 or Level 3 country (see
CDC
for more information)-or-
Planning any international travel
Name (First and Last):
*
Student/employee ID number:
*
College Affiliation:
*
Student
Faculty
Staff
WCJC email address:
*
example@wcjc.edu
Are you planning on traveling or are you currently traveling outside the United States?
*
Yes, I am planning on traveling/currently traveling
No, I am not planning on traveling/currently traveling
Where are you planning to travel?
*
Mainland China
Iran
Italy
South Korea
Japan
Other country not mentioned above (please specify below)
Specify another travel destination (if the country you are traveling to is not listed above, please specify here.)
Have you traveled to Mainland China, Iran, Italy, South Korea, Japan or any other international location since January 1, 2020?
*
Yes
No
If yes, please describe where and when you traveled:
What is the reason for your travel?
Personal Reasons
College business/college-sponsored purpose
Please describe your travel plans. Include U.S. departure and U.S. arrival dates and locations visited (city/country).
*
Are you intending to return to WCJC after your travel?
*
Yes
No
College Point of Contact: (For faculty and staff, please identify a point of contact at the College.) This may be your department chair or your supervisor. Include name, department, email address and phone number.
*
Personal Point of Contact: Please identify an emergency contact outside the college including name, relationship, email, and phone number
*
Are you aware that you must self-quarantine for 14 days prior to returning to the college if you have traveled to China, Iran, Italy, South Korea, Japan or any other country determined to be a Level 2 or Level 3 by the CDC?
*
Yes, I am aware I must notify the college after the 14-day self-quarantine
No, I was not aware I must notify the college after the 14-day self-quarantine
Submit
Should be Empty: