International Activity Approval Form

Complete this form for any Middlebury/MIIS-sponsored (funded, credited, supported, represented) program eight weeks before committing to the program.

Note:  If a request is approved, it is approved under the conditions at the time of approval.  If a (new) travel advisory is issued or the security situation changes, the proposal must be reconsidered.

Please indicate what Level of Travel Advisory your country/s of destination have per the US Department of State.
Briefly explain the purpose and an overview of your planned activities. For Travel Advisory Level 3 and 4 countries, please include the compelling reason for engaging in this project in this particular location.
Provide a brief overview of the accommodations (hotel, hostel, host family, apartment, dorm, campsite, etc.), including how they were chosen and/or vetted for safety and security:
Describe the inter-city and intra-city transportation methods for each location on your itinerary, including transportation to and from the airport.
If applicable, provide the name of your in-country partner, host organization, and/or placement agency. Please list all partners if there is more than one. Include websites, if available.
Describe on-site health, safety, and security support resources and services that are provided by your on-site host or others, if applicable (for example, on-site oreientation, familiarization tour of the area, accompaniment of staff, after hours emergency number, evacuation services, emergency protocols, etc.
Provide information on health risks (immunization needed, disease, water quality, on-site medical access and quality, etc.), and describe the mitigation strategies you will employ.
Provide information about the risk to personal safety (fear of bodily harm, terrorism, violent crime, kidnapping, theft, safety issues in housing, alcohol or substance abuse, etc.) and describe the mitigation strategies you will employ.
Please indicate any previous international travel experience of the traveler(s).
If you have submitted an application to your sponsoring department (i.e. CCI, CCE) that includes additional information about your project, please upload a copy of that application.
Files must be less than 10 MB.
Allowed file types: jpg jpeg doc docx pdf ppt xls.
Enter the city/country following by the dates (MM/DD/YY) for all places on the itinerary. (Ex. Paris 06/01/20-06/15/20 and Rome 06/15/20-07/01/20)