District Conference

Inbound Independent (Unaccompanied) Travel Form

Must be completed for independent (unaccompanied)travel outside of District 6220. YOUTH EXCHANGE OFFICER MUST SUBMIT THIS FORM TO DISTRICT INBOUND COORDINATOR FOR FINAL APPROVAL OF INDEPENDENT TRAVEL. NO TRAVEL IS ALLOWED UNLESS PRIOR PERMISSION HAS BEEN GRANTED BY HOST FAMILY, HOST ROTARY CLUB, NATURAL PARENT(S), AND DISTRICT INBOUND COORDINATOR. THIS PERMISSION PROCESS CAN TAKE UP TO 10 DAYS. DO NOT PURCHASE TICKETS BEFORE FINAL PERMISSION TO TRAVEL IS GRANTED. YOUTH EXCHANGE OFFICER MUST ALSO FILE INBOUND TRAVEL PERMISSION FORM AND SUBMIT TO DISTRICT INBOUND COORDINATOR Travel Guidelines and Travel Permission Form can be found under the Inbound tab at rye6220.org

REQUIRED INFORMATION
Student Name
Todays Date*
Host Club*
Student Cell Phone*
Student Email*
Destination*
Travel Dates*
Purpose of Travel*
Description of Travel Plans*
Places you will be staying. List names/cities of hotels. If traveling by air, include proposed airline itinerary (Flight number and schedule). Bus travel is not permitted. DO NOT PURCHASE TICKETS PRIOR TO APPROVAL.
Adult Person in Charge at Destination*

Submit Full Name, Submit Full Name, Address, Date of Birth and Social Security Number for all adults (age 18+) to District Student Protection Officer for background checks).Date of Birth and Social Security Number for all adults (age 18+) to District Student Protection Officer for background checks).
Relationship to Student*
Address*
Telephone Number(s)*
Has the student notified the school of this absence?*
Has the student received their natural parents permission?*
Has the student received their host parents permission?*
Has this student received their host Rotary clubs permission?*
Has the background check(s) been completed?*

Inbound Independent (Unaccompanied) Travel Form

REQUIRED INFORMATION