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["University Student Travel Insurance Registration Form"]
["Please complete this worksheet to ensure that you are covered by the Universities travel insurance policy, and to identify any times when you will need to provide for your own cover.  Complete the yellow cells."]
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["PERSONAL DETAILS"]
["UNIVERSITY STUDENT ID"]
["STUDENT SURNAME"]
["GIVEN NAME/S"]
["HOME PHONE"]
["MOBILE PHONE"]
["TYPE OF PROGRAM (eg. Exchange, Study Tour etc)"]
["OVERSEAS INSTITUTION (If applicable)"]
["MAIN DESTINATION COUNTRY"]
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["DURATION AND TRIP PLANNING"]
["Date of Departure from Tasmania Australia",null,null,null,null,null,null,null,"2019-01-01"]
["Date of Landing back in Tasmania Australia",null,null,null,null,null,null,null,"2019-05-01"]
["Total Number of Days of Travel Overseas",null,null,null,null,null,null,null,{"$f":"I16-I15","v":120}]
[]
["First day of overseas study program (including any orientation program)",null,null,null,null,null,null,null,"2019-01-10"]
["Last day of overseas study program (including any exam period)",null,null,null,null,null,null,null,"2019-04-15"]
["Number of days of travel for study purposes",null,null,null,null,null,null,null,{"$f":"(I20-I19)+1","v":96}]
["Number of incidental/private days of travel",null,null,null,null,null,null,null,{"$f":"I17-I21","v":24}]
["Percentage of private travel",null,null,null,null,null,null,null,{"$f":"I22/I17","v":0.2}]
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[{"$f":"IF(I17>365,\"Your total travel time is longer than permitted under the insurance policy.  You will need to arrange and pay for your own travel insurance.\",IF(I22/I17>0.3,\"Your private travel is longer than the amount permitted under the policy. You will need to arrange and pay for your own insurance for any private travel greater than 30% contact the insurance office finance.insurance@utas.edu.au.\",\"\"))","v":""}]
[{"$f":"IF(I17>180,\"Please contact the insurance office (finance.insurance@utas.edu.au) all travel between 180 days and 365 must be recorded and arranged on a per student basis\",\"\")","v":""}]
["TRAVELLER DECLARATION"]
["I hereby certify that:\n* I understand that the University’s overseas business travel insurance policy will only provide cover for approved programs , for a maximum of 365 days, with no more than 30%  private travel.\n* I have read and understood the Student Corporate travel insurance FAQ (http://www.utas.edu.au/finance/insurance/forms) \n* I have registered my travel arrangements with DFAT http://www.smartraveller.gov.au/.\n* I have read the DFAT Travel Advisory for the countries I am travelling to.\n* I have sought medical advice, have had all relevant vaccinations, and am fit to travel.\n* I have a passport with a minimum 6 month validity after return to Australia, and appropriate visas.\n",null,null,null,null,null,null,null,"Yes"]
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["I understand that VU strongly recommends that I should purchase any additional insurance from Ace-in-a-Suitcase. http://inasuitcase.aceinsurance.com.au/univic/homepage.aspx"]
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["Emergency Contact Details for Student Overseas Travel Insurance"]
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["The University of Tasmania holds a Corporate Travel Insurance Policy 5551714 (the Policy) with insurer, Accident and Health International Underwriting Pty Limited.\nUnder this Policy, students on approved University related travel are covered by the Policy  (subject to the relevant terms and conditions specified).  The travel must not be for more than  365 days and can have a maximum of 30% of days of private travel within that. \n University of Tasmania is not the insurer, does not guarantee or hold this right on trust for a student and does not act on behalf of Accident and Health International Underwriting Pty Limited.  The University of Tasmania is not an Authorised Representative of Accident and Health International Underwriting Pty Limited or any of its related companies. There is no obligation on a student to accept any of the benefits of the cover, and students are free to arrange their own insurance cover.  However, if a student wishes to seek cover under the University's travel insurance they can make claim under the Policy for the authorised travel period and they will be bound by the definitions, terms and conditions, exclusions and claims procedures set out in the Business Travel Insurance Product Disclosure Statement and Policy Wording, which is available from finance.insurance@utas.edu.au"]
[null,null,null,null,null,null,null,null,"Version 23 May 2019"]