Foreign Travel




		~ Foreign Travel Questionnaire ~ Get PDF Version of Form The purpose of this questionnaire is to provide the Chicago Counterintelligence Office with information needed to appropriately brief employees traveling to foreign countries. In some cases, completing and providing the Counterintelligence Officers with this information is sufficient and a briefing may not be required. In others, the Counterintelligence Officer may contact you to schedule a customized briefing. Please print your completed form and fax it to us at: 630/252-0185 Tell Us About Yourself... (Please use the tab button to go to next question.) First Name: Last Name: DOE Clearance Level: Laboratory or Site: Date of Birth: Country of Birth: Where Are You Traveling? City: Country: Departure Date: Return Date: Purpose of Travel: Who is sponsoring this trip? What hotel or other accomodations have been made for your stay? General Questions... Are you taking a laptop computer? Yes No Are you taking material of a sensitive nature? Yes No Do you have any medical concerns? Yes No Have you previously traveled outside the U.S.? Yes No If yes, where have you traveled? If you have any questions or concerns, please contact the Office of Counterintelligence: 630/252-5500
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~ Foreign Travel Questionnaire ~