ASU

As the Alabama State University works to protect the health and safety of our campus community, all University faculty and staff are required to inform University officials about any out-of-state or international travel through the self-reporting travel form below.

Your information will be submitted directly to the Assistant Vice President of Human Resources and will remain confidential.

As a reminder, if you or any of the members of your household exhibit symptoms associated with COVID 19, please stay home and call your supervisor.

Thank you for your help in ensuring the safety of our community.

Sincerely,
President Quinton T. Ross, Jr.

Name*

I am*

Faculty

Staff

College*

UC

COE

COHS

C-STEM

CLASS

COVPA

LWLC

Other college or department

Email*

Cell phone number*

Did you travel out of state? If so, where?

Have you displayed any of the following symptoms:

Fever of 100 or more

Chills

Runny nose

Difficulty Breathing or Shortness of Breath

Persistent Cough

Persistent Pain or Pressure in Chest

New confusion or inability remain alert

Bluish lips or face

Self-Reporting Travel Form