Student Handbook - NW Services

NORTHWEST SERVICESSTUDENT TRAVEL REQUEST FORMThis form is to be completed if a high school student would like to travel without his/her host family. Travelarrangements are NOT to be finalized until the form is signed by the Local Coordinator and returned to thestudent. This form is to be included with the DS2019 for travel outside of the United States. Failure to doso may result in disciplinary action. NWS is not responsible for any financial losses incurred. Students maynot travel without their host family during major family holidays or when it conflicts with other host familycommitments. Although it is a violation of the Student Visa to miss school, exceptions will be considered on acase by case basis.Travel will be considered on the basis of its educational value, your academic and behavioral record, and yourparticipation with your host family. Travel requests must be submitted to the LC a minimum of two weeksprior to the requested departure date.Please read and complete the entire form. All necessary signatures must be included for travel requests to becompleted.Student’s name:Travel date(s):Reason for travel:Mode of transportation:Destination(s) includeaddress(es), and landlinephone number(s). If more thanone destination please include dates for each:Chaperone’s Name(25 yrs or older)addressphone number(s):Name:Address:Home Phone:Cell Phone: