U of M Learning Abroad Center 2027

Please fill out the following form to provide Travel Leaders information for your study abroad program. If you have a deviation request - you want to do something different at the trip - please provide that information below.

Program Destination and Dates:

Once you confirm your selected flights, the university will be sent a copy for approval. After your flights are approved, you will receive an email with your trip details and ticket number.

First Name

Middle Name

If no middle name put NONE or NA

Last Name

Date of Birth

MonthDayYear

Gender

Please upload a photo or scan of your passport

Picture page only

Passport Number

Passport Expiration Date

Email

Phone

Permanent Home Address:

Supplemental Traveler details such as Airline Frequent Flyer Number and/or Known Traveler Number (TSA Precheck or Global Entry)

Example: Delta Skymiles 123456789 or Global Entry ZZZ5555

Travel Extras

Describe your ideal travel dates and cities if different

Flying from Chicago 2 days early, or returning from a different city on a different date, Parents flying to meet me in Florence

Phone and email for emergency contacts?

Example: Mary Jones - Mother - 555-555-5555 - mary@jones.net

Do we have permission to share your travel details and plans with your emergency contacts?

Others Notes to Agency:

Submit your form to Travel Leaders / Market Square Travel for processing.