UAMS.EDU

Student International Project Registration Form

  • Please Provide Traveler's Information:

  • Please provide your current local address
  • Please indicate your purpose of travel. Select all that apply:
  • Itinerary: Please enter below the arrival and departure dates for each destination in your itinerary. For multiple destinations, enter each destination location and dates.

  • In which college are you enrolled?

  • If yes, please provide the Name, ID number, and email address of the student/resident or faculty; you may enter them in the box provided above.
    UAMS does NOT support student travel, research or study in countries currently under a Travel Warning. Please refer to Academic Policy 1835.00 "Adhering to Overseas Travel Warning Policy" (provost.uark.edu/183500.pdf)
  • Passport/Visa

  • Emergency Contact Information

  • Emergency Preparedness

    Please indicate your plans for accessing emergency medical care:
  • For example, contacting the in-country emergency contact, proceeding to the nearest hospital (hospital name/address), etc.
  • For example, contacting the in-contry emergency contact, contacting the nearest US Embassy or Consulate, calling the number on the AIG travel insurance card, etc.
  • Acknowledgements:

  • This field is for validation purposes and should be left unchanged.