FIU Travel Petition for Level 4 Country Destinations

Effective July 1, 2022, only countries with a LEVEL 4 ADVISORY by the U.S. DEPARTMENT OF STATE or CDC require a petition. For all other countries, the approved Travel Authorization Request (TAR) suffices.

This petition form should only be completed by FIU employees, including students employed by FIU.

Students not employed by FIU planning to travel abroad must complete the mandatory Office of Education Abroad Pre-Departure Orientation regardless of the advisory level. Please contact edabroad@fiu.edu for details.

Traveler's Information
Last Name *
First Name *
Panther ID *
Email Address *
How may we get in touch with you while you are abroad (email or phone, if not listed above, please list here? *
Phone Phone * - ### - ### ####
Are you a student, member of the faculty, staff member? (check all that apply) *

Are you a student, member of the faculty, staff member? (check all that apply) Undergraduate student, not employed at FIU Undergraduate student, employed at FIU Graduate student, not employed at FIU Graduate student, employed at FIU Faculty Staff
FIU Home Department *
Please Name Your Supervisor (employees) or Faculty Mentor (students) *
Trip Information
Departure date Departure date * / MM / DD YYYY
Return date Return date * / MM / DD YYYY
Destination country (or countries, if applicable) *
Destination city/cities (list all, including layovers where applicable) *
Please state what permit you hold to enter the foreign country *

Please state what permit you hold to enter the foreign country Citizenship Permanent residency Visa (i.e. for work) Other Other
State funding source for this trip (activity/project # that will be charged; enter n/a if paid for by third party) *
Maximum of 9223372036854776000 allowed. Currently Entered: 0 .
Purpose of trip *

Purpose of trip Conference Field Work Meeting Recruiting Research Symposium Teaching Training Workshop Other

Select all that apply.
Means of travel

Means of travel Airplane Rental vehicle Private vehicle Public transportation Train Other

Select all that apply.
Was a Travel Authorization Request (TAR) already submitted and completed in Panthersoft?

Was a Travel Authorization Request (TAR) already submitted and completed in Panthersoft? Yes No Don't know
Upload trip itinerary

Attach Files
U.S. Department of State Advisory Levels

U.S. Government Travel Guidance
Please carefully review the Level 4 Advisory for your travel destination(s)

Visit https://travel.state.gov/content/travel/en/international-travel.html
Justification

Please describe why travel is essential.
Describe the activities to be carried out in all locations: *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
If applicable:
-
Describe the logistics in your destination country. Who (name individual and/or organization) will host you? Where will you be accommodated? How will you move from one location to the next? If you are close to isolated conflict areas, how do you plan to protect yourself/other travelers with you? *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
If applicable:
-
Describe the impact on your academic/professional work should you not be allowed to travel at this time: *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
If applicable, answer the following:

For students:
- does this trip contribute towards timely degree completion?
- does your faculty supervisor/mentor support this trip?

For faculty/employees:
- does this trip directly impact preeminent status and/or our performance metrics?
- does this trip boost institutional reputation?
- does your supervisor support this trip?
- is this work relevant to national security?
Describe how you would mitigate a potential cancellation of the trip at this time (in other words, what would you be able to achieve if you had to work remotely): *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
List any potential financial losses should you not be allowed to travel at this time: *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
If no financial losses are expected, please insert n/a.
Explain how you plan to protect yourself to avoid a potential COVID-19 infection and how you will observe the COVID-19 protocol and requirements at the travel destination. *
Maximum of 500 characters allowed. Currently Entered: 0 characters.
Other Travelers

Please submit names/PIDs of any other FIU employees or students joining the same itinerary. Should others join only part of your trip/have a separate itinerary, please submit a separate petition.
Name and Panther IDs of other FIU travelers
If traveling with students, please paste below/upload below a day-by-day itinerary so that we know when/where you and the students will be during the travel period.
Upload Day-to-Day Itinerary (for student trips only).

Attach Files
Please carefully review the advisory by the US Department of State:

US Dept of State:
https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
Referencing the US Dept of State's advisory for your destination, please respond specifically to security warnings for crime, civil unrest, kidnappings etc., and how you plan to avoid exposure to such risks:
Maximum of 500 characters allowed. Currently Entered: 0 characters.
Section Break

This is the description of your section break.

FIU Travel Petition for Level 4 Country Destinations

FIU Travel Petition for Level 4 Country Destinations

Traveler's Information

Trip Information

U.S. Department of State Advisory Levels

Please carefully review the Level 4 Advisory for your travel destination(s)

Justification

Other Travelers

Please carefully review the advisory by the US Department of State:

Section Break