Fillable FacultyLedPermissiontoPlanForm Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFacultyLedAp

Fill Online, Printable, Fillable, Blank FacultyLedPermissiontoPlanForm Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFacultyLedAp Form

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FacultyLedPermissiontoPlanForm Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFacultyLedApplication onIPSwebpage:ips.wcu.edu (Western Carolina University)

On average this form takes 13 minutes to complete

The FacultyLedPermissiontoPlanForm Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFacultyLedAp form is 3 pages long and contains:

  • 5 signatures
  • 0 check-boxes
  • 30 other fields

Country of origin: US
File type: PDF

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Faculty‐LedPermissiontoPlanForm 1
Faculty‐LedPermissiontoPlanForm
Updated3/11/2020
Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty‐
Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFaculty‐LedApplication
onIPSwebpage:ips.wcu.edu
LeadInstructor:
Co‐Instructor:
CourseName:
CoursePrefix&Number:
NumberofCredits:
Prerequisites:
ProposedTravelDates:
ProposedCourseDates:
Country:
CityorCitiestovisit:
MinimumNumberofStudents TargetNumberofStudents MaximumNumberofStudents

DestinationThreatLevel:
VisitthestateDepartmentwebsiteandsearchforyourdestinationcountry:
https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html.html
DestinationThreatLevel(1,2,3or4):
IfdestinationthreatlevelisaboveLevel2,pleaseanswerthefollowingquestionsbelow:
Arethereothercountrieswithlowerthreatlevelsthatcouldbeconsidered?
Haveyouvisitedthiscountryonuniversitybusinesspreviously?
Howrecentlywasthethreatlevelelevated?
Faculty‐LedPermissiontoPlanForm 2
Isavisarequiredtovisitthiscountry:YESNO
ProgramLocationSafetyAssessment:
ReviewtheCentersforDiseaseControlandPreventionwebsite(wwwnc.cdc.gov/travel/),theU.S.
DepartmentofStatewebsite(travel.state.gov),andOverseasSecurityAdvisoryCouncil(OSAC)
(www.osac.gov)forthelocationsandroadtravelincludedinyourprogram.
Areanyissuesrelatedtoprogramlocation,saferoadtravel,cleanwateraccess,medicaladvisories,
etc.,listedintheseresources?Ifso,provideasummaryoftheinformationhere.
ExportControl:
Reviewthefollowinginformationaboutexportcontrol:https://www.wcu.edu/learn/office‐of‐the‐
provost/research/sponsored‐research/research‐compliance/export‐control.aspx
Third‐PartyProvider:
Ifyouplantouseathird‐partyprovider,pleaselistthenamebelow:
Listservicesthatwillbeprovidedbythird‐party:
Completethefollowingitemstoproceedwithyourtrip:
Thiscanbedoneindependentlyofthepermissiontoplanform.
‐ PrintandcompleteaPolicy100Form–oneformforeachinstructor.Havesupervisoranddean
signature.DonotneedprovostsignatureasthiswillbedoneonChromeRiver.
*Processsubjecttochange.
Linktotheformislistedhere:
https://www.wcu.edu/WebFiles/PDFs/Policy_100_Travel_Form_LGL_update.pdf
‐ LogintoChromeRiverandaddChelseaPressleyasyourdelegate
o Travel.wcu.edu
o Clickyournameatthetoprightcornerandselect“Settings”
o Click“Delegates”andfindChelseaPressley
‐ EmailyourcompletedPolicy100toChelseaPressley–shewillsubmityourpreapprovaland
reimbursementonyourbehalf.
Faculty‐LedPermissiontoPlanForm 3
Bysigningbelow,youattestthattheinformationprovidedonthisPermissiontoPlanformisaccurateto
thebestofyourknowledgeatthedateofcompletion:
AcknowledgementofFacultyMember:
PrintName: Signature: Date:

Approvals:
ApprovalLevel: Signature: Date:
DepartmentHead:

Dean:

NextSteps:
Pleasesendalldocumentsonthechecklist(page3)toInternationalPrograms
forreview.DocumentationwillbesentbyIPStotheProvost’sofficeforfinal
approval.Pleasesendtofacultyledtravel.wcu.eduorinInterofficemail–109
CampBuilding
ApprovalLevel: Signature: Date:
InternationalPrograms&Services:

Provost:

AdditionalApprovals(ifrequired):

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FacultyLedPermissiontoPlanForm Pleasenote:ThepurposeofthisformistonotifyInternationalProgramsofyourintenttoleadaFaculty Ledtrip.Approvalofthisformallowsyoutoproceedwithplanningyourtrip;seeFacultyLedApplication onIPSwebpage:ips.wcu.edu (Western Carolina Un

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Completed 1 September 2020

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