School Exchange Program Pre-Arrival Security Form
Student Information
Full Name
Date of Birth
Nationality
Passport Number
Contact in Home Country
Contact Name
Relationship
Phone Number
Email Address
Arrival Information
Date of Arrival
Flight Number
Arrival Time
Arrival Airport
Emergency Contact During Exchange
Emergency Contact Name
Phone Number
Email Address
Relationship
Health & Medical Information
Medical Conditions (if any)
Allergies (if any)
Health Insurance Provider
Policy/Insurance Number
Security & Safety Awareness
Have you received safety/security briefing from your home institution?
Yes
No
Do you have any safety concerns or requirements?