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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 5, Chapter 8:  Manual Exhibit M

Notification of Foreign Travel


TO: Office of International Affairs
Office of the Secretary

FROM: Director
Through: Area Director____

SUBJECT: Notification of Foreign Travel


Traveler’s Name, Title, Organization

Telephone Number__________ Cellular Telephone Number __________ E-mail Address _________________________

Indicate if Senior Executive Service or above, or equivalent: Yes_______ No _______

Purpose of Travel:

Relationship to Department Objectives:

Itinerary:  (Include cities/countries to be visited and dates. Account for all time on official business or leave.)

Anticipated Contact With U.S. and Foreign Officials:

State Department Post Services Requested:

Amount and Source of Funding:

Contact Information While in the Foreign Country:  (The hotel name/address/telephone number; name/address/telephone number of persons with whom the traveler will meet; the conference location name/address/telephone number: the coordinator's name/address/telephone number; and the traveler's cell phone number (s) or pager number(s).)

Office of Secretary: Approval_______ Disapproval_______ Date______________
(Required for SES and above, or equivalent)


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