★[for TUAT students] 海外派遣中の事故、体調不良（ケガ、COVID-19感染含む）に関する報告　Report of incident and/or bad health condition (including COVID-19 infection or having injured) during Study Abroad　　　　　　　　　
海外派遣中に事故、体調不良、ケガ等が発生した場合、速やかにこのフォームを記入して大学に連絡してください。（必要事項を記入して「送信」ボタンを押して下さい。）

※本報告書で送信いただいた情報は、当該学生を支援する目的に必要な範囲で、学内関係者間で共有することがありますので、ご了承ください。

If you have an incident and/or bad health condition (including COVID-19 infection or having injured)  during your study abroad, please inform to TUAT as soon as possible via completing this google form. (please press the "send（送信）"button after fill in the information on the form.)

※Please note that the information you submit in this report may be shared among related parties on campus as necessary in order to support you、

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名前　Name *
連絡先（電話番号）Contact information (phone number) *
連絡先（メールアドレス）Contact information (e-mail address) *
学籍番号　Student ID number
所属　Faculty or Graduate School you belong to
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