Domestic Short Term Program Travel Intent Form

Student Name

Student ID Number

Program Name

Major

City

State / Territory

Start Date

End Date

I choose to arrive *BEFORE* the Start Date of the Program.

(I am choosing to arrive in said City/State/Territory and/or travel to another City/State/Territory of my own accord, and agree that my academic relationship with USF related to my participation in the USF Short Term Domestic Program begins on the official Start Date.)

I choose to depart *AFTER* the End Date of the Program.

(I am choosing to remain in said City/State/Territory and/or travel to another City/State/Territory of my own accord, and agree that my academic relationship with USF related to my participation in the USF Short Term Domestic Program ends on the official End Date.)

I certify that all of the information on this form is true, correct, and complete.