Student Travel Request Form

The Student Travel Request Form must be completed by *all Comox Valley International students at least five business days before an anticipated trip outside the Comox Valley.

*Includes One for One (reciprocal) exchange students.

Do I need to complete this form?

You need to complete the Student Travel Request Form, if you are a student travelling:

- outside the Comox Valley without your homestay parent/s;
- outside the Comox Valley with a natural parent/s;
- to another country other than your home country;
- outside the Comox Valley for more than three (3) nights with your homestay parent/s/

You do NOT need to complete the Student Travel Request Form, if you are a student travelling:

- outside the Comox Valley for less than three (3) nights with your homestay parent/s/
- as part of a school-sanctioned trip (e.g. sports team, field trip, ISP Activities)

Travel Requirments

Students travelling outside of the Comox Valley are required to have a chaperone at least twenty five (25) years old.

**Any student who travels without approval will be subject to discipline.

Student Travel Request

Student Information
To be completed by the international student with his/her homestay.
Student Name*
First Last
Student Email*
Departure Date*
MM slash DD slash YYYY
Return Date*
MM slash DD slash YYYY
Trip Details*
Describe the complete trip plan. Upload your flight itinerary, bus tickets, ferry tickets, etc. below if applicable.
Purpose of Trip*
Upload Travel Related Documents
If you have digital copies of your travel details you can upload them here.
Drop files here or

Accepted file types: jpg, pdf, Max. file size: 100 MB, Max. files: 5.
Chaperone Information
Enter the required information of the adult (25 years or older) with whom you will be staying during your trip.
Chaperone Name*
First Last
Chaperone Age*
Please enter a number from 25 to 99.
Chaperone must be 25 years or older
Chaperone Gender*
Chaperone Relationship to Student*
Chaperone Phone Number*
Chaperone Email*
Address*
Enter the full address of the house, condo, apartment or hotel where you will be staying. If a hotel, include the name of the hotel on the "Street Address" line.

Street Address City Province/State/Region Postal Code/Zip Country
HOMESTAY INFORMATION
To be completed by the homestay parent(s).
Homestay Parent's Name*
First Last
Homestay Email*
I have contacted the chaperone listed on this form and confirmed he/she is 25 years or older.*
- Yes
- No
I approve of the out of district travel plan for the international student residing in my home.*
- Yes
- No
Homestay Parent's Signature*
I understand and accept that signing this electronic form constitutes a legal signature.
Name
This field is for validation purposes and should be left unchanged.

Student Travel Request Form

Student Travel Request

Student Information

Chaperone Information

HOMESTAY INFORMATION

Comox Valley International Student Program

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