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Report of International Travel
If traveling internationally between now and May 31, 2020, please complete this brief survey on/by Friday, February 28, 2020 to self-report this travel to the Special Committee to Review Coronavirus Outbreak.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Cell Phone Number
*
Your answer
Where is your travel destination?
*
Your answer
Departure date?
*
MM
/
DD
/
YYYY
Return date?
*
MM
/
DD
/
YYYY
What organization is sponsoring the trip? If none, answer N/A.
*
Your answer
A copy of your responses will be emailed to the address you provided.
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