Request for Permission to Travel

According to the terms of the exchange program agreement with Global Horizons USA, students must have signed permission from their natural parents as well as get the approval from host family and the school, if they are traveling for a period longer than a weekend. Regardless of the duration of travel, if traveling by bus, train or plane this permission form must be signed. Permission from the school is required if they will be missing any classes.

Student name*

First Name Last Name

Local Coordinator email address*

example@example.com

Email address of one of the host parents*

example@example.com

Email address of one of the parents in the home country*

example@example.com

Departure from host community*

Date

Return to host community*

Date

Destination*

Address where you will stay*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Reason of travel*

Mode of travel*

Name of the responsible adult*

First Name Last Name

Phone number of the responsible adult*

Please enter a valid phone number.

Email of the responsible adult

example@example.com

How many days will you be absent from school?*

Did the school approve your travel? (if absent from school)*

YesNoI am not missing any school days

Did your host family approve your travel?*

YesNoI am travelling with my host family

If travelling by airplane, please upload your itinerary

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Natural Parent 1*

Clear

Natural Parent 2

Clear

If you are in the USA on a F-1 visa and your trip is OUTSIDE the USA, be sure that your F-1 is a Multiple Entry Visa and the I-20 form has been signed on the last page.