International Emergency Contact Information

Please provide the following information so that the Center for International Education can contact you while abroad in the event of an emergency during the course of your study abroad term. This information will be used only in the event of a true emergency, and only if UMW is unable to contact you directly.

Name*
First Last
Banner ID*
UMW Email*
Personal/alternate Email
International Phone Number
If you have an international cell phone or VOIP phone, or have been given a number where you can be reached at a residence during your time abroad please provide it, including the country code.
Study Abroad Program or Host University*
Program Start Date (mm/dd/yyyy)*
Program End Date (mm/dd/yyyy)*
US Emergency Contact*
Whom should we contact in the event that we are notified of an emergency event during your time abroad? (Typically a family member).
First Last
US Contact Phone*
US Contact Email*
Relationship to You*

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