This form is required for any faculty or staff member intending to develop and lead a Study Abroad program within EHHD.  Preferred due date: 1 year in advance of expected departure.

Submit to: Dr. Kayte Kaminski, Assistant Dean ([email protected])

                                                                                    

  1. Faculty/Staff (Program Leader) Name:                                              Department:             

 

Collaborator(s):                                                                                                  Department(s):

 

  1. Working title of proposed program:

Attach a working abstract at Appendix A 

 

  1. Intended program dates:

 

  1. Estimated cost to student: $

 

  1. Faculty leader travel costs for approved Office of International Programs faculty led programs are covered by the student’s fees if the minimum number of students are accepted into the program. Is there additional funding that is required and if so, what for, and what is your intended funding source?

 

 

 

  1. Have you attended an Office of International Programs’ Study Abroad information session?               ____YES              ____NO

 

  1. Who is your target audience for student participants?

 

 

 

  1. Have you discussed your plans with your department head
    and your departmental program/team leader? ____YES              ____NO

 

  1. Have you discussed your plans with the Assistant Dean /
    EHHD Coordinator of International Programs? ____YES              ____NO

 

 

Departmental Approval to Proceed (signature):                                               Date:

 

 

 

EHHD Dean’s Approval to Proceed (signature):                                                Date:

 

 

 

Signed Copies to:

_____Program/Team leader (original)

_____Assistant Dean, EHHD Coordinator of International Programs (copy)


 

 

Appendix A

Program Draft Abstract

Please succinctly describe the purpose and scope of the proposed Study Abroad Program