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 All fields are required.

First Name :
Please enter legal first name (i.e. "Michael" not "Mike")

Middle Name :
Please enter "None" if you don't have middle name

Last Name :

Gender :

Date of Birth :

Passport Number :

Issue Date :
(mm-dd-yyyy)

Expiration Date :
(mm-dd-yyyy)

Issuing Country :

Cellphone :

E-mail :
@husky.neu.edu
(NU email addresses only)

Program :

Term :

 
I want to take the group flights roundtrip from/to Boston
on the official start and end dates of the program.

 
I don’t want to fly from Boston with the group for the start of the program,
but do want to fly back to Boston with them at the end of the program.
Instead of flying over with them from Boston, I want to fly from .

 
I want to fly from Boston with the group for the start of the program,
but don’t want to fly back with them at the end of the program.
Instead, I want to fly from (insert city abroad)
back to on (fill in date).

 
I don’t want to fly with the group in either direction.
Instead of flying over with them from Boston,
I want to fly from and instead of flying home with them,
I want to fly from (insert city abroad)
back to on (fill in date).

 
* If you choose options 2, 3, or 4 you MUST go to https://web.northeastern.edu/safetyforms/flight-deviation/
and submit Northeastern’s Flight Deviation Form. Also, if the cost of
your ticket is more than the cost of the group flight, you will be
responsible for paying Academic Studies Abroad the difference in price.
The amount due CANNOT be billed to your Northeastern account and will
have to be paid by check or credit card.

Username :
Username should be minimum 6 characters and maximum 20 characters long.
Spaces are not allowed.
Allowed characters Aa-Zz , 0-9, . , _ , - .

Password :
Password should be minimum 6 characters and maximum 32 characters long.
Spaces are not allowed.

Confirm Password :

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