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926 E. Dunklin Street
Jefferson City, MO 65102
Ph: (573) 681-5473
Fax: (573) 681-5474
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_______________________ ________________________ ____________________ ________________
Last Name First Name Nickname LU Student ID
____________________________________________________ __________________________________________
Email Phone #
Country of Origin ________________________________________
I am currently in the following city and country:__________________________________________________________________
I am traveling to Lincoln University by (please check all that apply):
_____Air _____Train _____Car _____Bus _____Shuttle
My travel itinerary is as follows. Please include all departure cites of departure and arrival, date, times, flight numbers, etc.
First Travel Plan
Method of Transportation (check all
that apply)
Airline (if flying) and Flight/Train/Shuttle No.#
Second Travel Plan
Method of Transportation (check all
that apply)
Airline (if flying) and Flight/Train/Shuttle No.#
Third Travel Plan
Method of Transportation (check all
that apply)
Airline (if flying) and Flight/Train/Shuttle No.#
FOR ISC USE ONLY:
Received on __________________________ by____________________________ Student File Updated on: ___________________________
(Month/Day/Year) (ISC advisor’s name) (Month/Day/Year)