Notification Of International Travel - Faculty And Staff - Centrally Originated Transaction Approval Queues
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1
2Notification of International Travel for Faculty/Staff
New Mexico State University
Accounts Payable – Travel Office
The Notification for International Travel Form should be completed by faculty/staff at least 20 days prior to date of
non-personal international travel. The completed forms must be approved by the Dean/VP for the college or unit
sponsoring the travel, and forwarded to International Programs at MSC 3567, Garcia Annex RM 246. Any questions,
please call International Programs (575) 646-7041
Traveler Information:
Name: ____________________________________________________________________________________________ Banner ID: ______________________________
DOB:_________/__________/__________Citizenship:__________________________________________________________Gender:_____Male _____Female
Contact Numbers (Cell/Home/Work): _______________________________ /________________________________ /_________________________________
Email: ______________________________________________________ Emergency Contact Name: ___________________________________________________
Emergency Contact Phone: ____________________________ Emergency Contact Email: _____________________________________________________
Preparer Information:
Name: _____________________________________________________ Department: ___________________________ Prepared Date: ______________________
Contact Number: __________________________________ Email: _________________________________________________________________________________
If the traveler named above is accompanied by students, the Student International Travel Form must be completed for each student.
Trip Information:
Starting Point: _____________________________________ Destination(s): _______________________________________________________________________
Departure Date and Time: ___________________________ ________________ Return Date and Time: ___________________________ _______________
A purpose for the non-personal international travel must be entered in the box below. The index, fund, account number and
amount should be entered, even if the cost at this point is only an estimate.
Index (FOPAL)
Fund
Account
Amount ($)
U.S Travel Warning:
Travelers must check the travel advisories available at
Advisories include Travel Alerts or Travel Warnings. Please attach a dated copy of the Travel Warning viewed.
If a warning has been issued, traveler is also required to sign the Waiver, Release and Hold Harmless Agreement for
each destination for which a travel warning has been issued. The waiver can be accessed at
,%20Release%20and%20Hold%20Harmless.pdf
__________ Traveler has attached dated copies of warnings issued by the U.S. Department of State
__________ Traveler has attached the Waiver, Release and Hold Harmless Agreement form, if any of the traveler’s destinations
are listed on the Travel Warning List.
Campus Health Center:
It is recommended that faculty and staff preparing to travel abroad make an appointment at the Campus Health Center to
seek medical advice pertaining to the traveler’s destination. Some vaccinations are a part of a series which require
completion for full immunity. A six week travel lead time is recommended.
International Health Insurance:
Faculty and staff members that want to purchase international health insurance, will need to contact International Programs
for coverage and rates. International Programs will process the insurance and an email containing policy information and
Insurance ID will be sent to the traveler.
______Bill to Index # Above;______Bill to Credit Card #____________________________________________Exp________;______Payment Attached
__________________________________________________________________
______________________________________________________________________
Dean/VP Name (Please Print)
Dean/VP Signature Approval
Date
Revised – 09/15/2011
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