Request for Permission to Travel

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. Global Horizons USA must also have a signed “hold harmless agreement” from the natural parents for the duration of the absence if travel is outside the borders of the USA.
Student name *

First Name Last Name
Departure from host community *

Month Day Year
Date
Return to host community *

Month Day Year
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 *

Car Airplane Bus Train Other
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) *

Yes No I am not missing any school days
Did your host family approve your travel? *

Yes No I am travelling with my host family
If travelling by airplane, please upload your itinerary

Cancel of
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.
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