Fillable Fillable Summer STEM Contact And Travel Form

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Fillable Summer STEM Contact And Travel Form

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UNITED STATES NAVAL ACADEMY
SUMMER STEM CONTACT AND TRAVEL INFORMATION
This form must be submitted for every STEM participant. It is imperative that all information be current and reliable.
STUDENT’S NAME
STUDENT’S CELL PHONE #
PARENT/GUARDIAN NAME
PARENT/GUARDIAN PHONE #
EMERGENCY CONTACT NAME
EMERGENCY CONTACT RELATIONSHIP
EMERGENCY CONTACT PHONE #
PLEASE INDICATE YOUR STUDENT’S METHOD OF TRANSPORTATION
SELF TRANSPORTATION ☐YES ☐NO
Arrival Day Drop Off 11:00am - 5:00pm Departure Day Pick Up 10:00am-12:00pm
ARRIVAL INFORMATION
DEPARTURE INFORMATION
PERSON
RESPONSIBLE FOR
DROP OFF
PERSON
RESPONSIBLE FOR
PICK UP
DROP OFF TIME
PICK UP TIME
CONTACT PHONE #
CONTACT PHONE #
AIR TRAVEL ☐YES ☐NO
Is your student traveling alone? ☐YES ☐NO (if NO, please skip)
*If traveling independently, please complete this section. Please note that Naval Academy transportation will be
available from BWI airport only. Flights must be booked within the following time periods.
Arrival Day 9:00am-4:00pm Departure Day 2:00pm-4:00pm
ARRIVAL INFORMATION
DEPARTURE INFORMATION
ORIGINATING AIRPORT
AIRLINE
AIRLINE
FLIGHT #
FLIGHT #
CONNECTING AIRPORT
CONNECTING FLIGHT #
ARRIVAL TIME
DEPARTURE TIME
UNACCOMPANIED MINOR STATUS: Has your student been officially designated as an
UNACCOMPANIED MINOR by the airline (as opposed to an “UNACCOMPANIED YOUTH”)? If so, you will
be provided with the name of the Midshipman escort one week before arrival day. ☐YES ☐NO
TRAIN TRAVEL ☐YES ☐NO
Is your student traveling alone? ☐YES ☐NO (if NO, please skip)
*If traveling independently, please complete this section. Please note that Naval Academy transportation will be
available from BWI airport only. Train rides must be booked within the following time periods.
Arrival Day 9:00am-4:00pm Departure Day 2:00pm-4:00pm
ARRIVAL INFORMATION
DEPARTURE INFORMATION
ARRIVAL TRAIN #
DEPARTURE TRAIN #
ARRIVAL TIME
DEPARTURE TIME
My child will need bus transportation to USNA from BWI. ☐YES ☐NO
My child will need bus transportation to BWI from USNA. ☐YES ☐NO
SPECIAL NOTES:
PLEASE COMPLETE AND EMAIL THIS FORM TO SUMMERSTEM@USNA.EDU WHEN ALL TRAVEL
PLANS HAVE BEEN FINALIZED.
FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE Any misuse or unauthorized disclosure can result in both civil and
criminal penalties.
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Fillable Summer STEM Contact And Travel Form

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Completed 17 March 2020

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