Elliott School Capstone Group Proposal:

Instructions:
Be sure to complete this form with as much detail as possible.

All proposals will be reviewed by the Elliott School after the Capstone Funding application
submission deadline. Final travel approval will be sent by the Office of International Programs (OIP).
All reimbursement requests are contingent upon OIP travel approval.

Please note that all high or extreme risk destinations (defined below) will require an extra level of
review and approval from GWs Associate Provost for International Programs. The Office of
International Programs will coordinate this review on your behalf after receiving initial approval from
the Elliott School. To facilitate this process, you should ensure that you include as much information
as possible in your risk mitigation plan along with any additional information that can be helpful in
determining your experience in high risk destinations, such as prior travel, in-country support
networks, language abilities, etc.

GW Accommodation and Automobile Policy Reminder: According to GW Policy, students traveling for
GW-related activities may not rent cars while abroad or utilize peer-to-peer lodging, such as AirBNB
or FlipKey. If you were awarded a travel grant, GWs financial departments would deny any
reimbursement request if these services were used. Group travel with proposed peer-to-peer lodging
or rental cars will not be approved until alternate plans are presented.

Before submitting your proposal, you should review your proposal details with your capstone advisor.

(*) Indicates the question is required.

1. Dates abroad: (*)

2. Location(s) (both city/cities and country/countries) (*)

If more than one location, please list dates spent in each location.

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3. Purpose of travel: (*)

If research, briefly indicate the topic(s) or question(s) of interest.
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4. ESIA Capstone Team Members (*)
Please list all team members (AND THEIR GW EMAIL) traveling to your destination. Please do not
list any team members who will not be traveling abroad. If a team member plans to travel to a
different destination, that team member must complete a separate proposal.

Please include the GW Email address of each team member traveling to your destination.

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5. Risk Ratings (*)

In the following questions, you are required to review and address Risk Ratings for your
destination, as determined by GWs international insurer, HTH Worldwide (HTH).

To acquire your destinations risk ratings, please visit HTHs risk information website. Please
consult these instructions for assistance in registering with the website and/or locating your
destinations Risk Ratings.

PLEASE NOTE: When there is a discrepancy between country versus city risk ratings, the
Office of International Programs will defer to the highest risk rating.

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Instability Risk Rating

Once you have obtained the Instability Risk Rating from HTHs website, please enter the rating
below:

6. High/Extreme Instability Risk Mitigation (*)

If the HTH report has rated your destination as a High or Extreme risk for Instability, please explain
below how you plan to mitigate these risks while abroad. This plan should address each risk in detail.

If your destination is not rated High or Extreme for Instability by HTH, please enter "N/A" below.
You may also upload a copy of your external risk mitigation plan (if you have one) by clicking on the
folder icon below and selecting a file from your computer.
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7. Terrorism Risk Rating (*)

Once you have obtained the Terrorism Risk Rating from HTHs website, please enter the rating
below:

8. High/Extreme Terrorism Risk Mitigation (*)

If the HTH report has rated your destination as a High or Extreme risk for Terrorism, please explain
below how you plan to mitigate these risks while abroad. This plan should address each risk in detail.

If your destination is not rated High or Extreme for Terrorism by HTH Worldwide, please enter "N/A"
below.
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9. Criminal Activity Risk Rating (*)

Once you have obtained the Criminal Activity Risk Rating from HTHs website, please enter the
rating below:

10. High/Extreme Criminal Activity Risk Mitigation (*)

If the HTH report has rated your destination as a High or Extreme risk for Criminal Activity, please
explain below how you plan to mitigate these risks while abroad. This plan should address each risk
in detail.

If your destination is not rated High or Extreme for Criminal Activity by HTH, please enter "N/A"
below.
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11. Health and Medical Risk Rating (*)

Once you have obtained the Health and Medical Risk Rating from HTHs website, please enter the
rating below:
12. High/Extreme Health and Medical Risk Mitigation (*)
PLEASE NOTE that, in addition to the Health and Medical Risk Rating, you should consult other
destination-specific medical information available through HTHs CityHealth Profile feature. Please
see Step 12 of these instructions to help locate this information.

If the HTH report has rated your destination as a High or Extreme risk for Health and Medical, please
explain below how you plan to mitigate these risks while abroad. This plan should address each risk
in detail.

If your destination is not rated High or Extreme for Health and Medical by HTH, please enter "N/A"
below.
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13. Transportation Risk Rating (*)

Once you have obtained the Transportation Risk Rating from HTHs website, please enter the rating
below:

14. High/Extreme Transportation Risk Mitigation (*)

If the HTH report has rated your destination as a High or Extreme risk for Transportation, please
explain below how you plan to mitigate these risks while abroad. This plan should address each risk
in detail.

If your destination is not rated High or Extreme for Transportation by HTH, please enter "N/A" below.
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15. Other Risk Rating (*)

Once you have obtained the "Other" Risk Rating from HTHs website, please enter the rating below:

16. High/Extreme Other Risk Mitigation (*)

If the HTH report has rated your destination as a High or Extreme risk for "Other", please explain
below how you plan to mitigate these risks while abroad. This plan should address each risk in detail.

If your destination is not rated High or Extreme for "Other" by HTH, please enter "N/A" below.
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17. U.S. Department of State Travel Warning/Alert: (*)

To determine whether your destination has been issued a Travel Warning or Alert from the U.S.
Department of State, please visit the Bureau of Consular Affairs website.

Does your destination have a U.S. Department of State Travel Warning or Alert?

Please select one

18. U.S. Department of State Travel Warning/Alert Risk Mitigation: (*)

If your destination has been issued a Travel Warning or Alert, please explain how you will address
the risks or issues raised by the U.S. Department of State in its online briefing.

If your destination has not received a Travel Warning or Alert from the U.S. Department of State,
please enter "N/A" below.
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19. Visa required? (*)

To determine whether you need a visa for your trip, you should consult your host countrys
immigration website and/or get in touch with the local embassy/consulate in Washington, DC.

Please select one

20. Vaccinations Required? (*)

Please review your destination's vaccination information listed on the State Department's country-
specific travel page. and the Center for Disease Control's country-specific Traveler's Health page. to
determine whether or not any vaccinations are required.
If yes, please indicate which vaccinations are required.

Please select one

21. Outbound travel details: (*)
Please enter all available travel details for your outbound trip, even if they are still tentative.

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22. Return travel details: (*)

Please enter all available travel details for your return trip, even if they are still tentative.

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23. In-country transportation details: (*)

Please be sure to describe how you will be getting around while in-country, whether between cities or
within the same city.

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24. In-country cell phone number: (*)

Please include all international area codes.

25. Local address of in-country accommodation: (*)

Please be sure to include your accommodation's name (if applicable, e.g. a hotel name), street
address, city, state (if applicable), country, and zip code.

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26. Name of in-country accommodation coordinator: (*)

27. Phone number (landline) of in-country accommodation: (*)
Please include all international area codes.

28. Email address of in-country accommodation: (*)

29. Website of in-country accommodation: (*)

If not applicable, please enter "N/A."

30. Name of in-country program: (*)

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31. Name and Contact Information for In-Country Client (*)

This person should know your whereabouts and should be able to get in touch with you.

32. Address of in-country program: (*)

Please be sure to include your program's street address, city, state (if applicable), country, and zip
code.

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33. Phone number of in-country program: (*)

34. Email address of in-country program: (*)

35. Website of in-country program: (*)

36. Additional information (*)
Please enter any additional information about yourself or your trip that may be relevant or helpful,
e.g. if you have any family, friends, or other support structures in the destination(s) you will be
traveling to.