Summer 2021 Faculty-Led Study Abroad Program Proposal Form Question Title * 1. Please complete the following information: Name Title Date of Proposal Submission Email Address Department Campus Phone Question Title * 2. Please complete the following information in regards to your program: Program Location Proposed session in which the program would be initiated (spring break, maymester, summer I, summer II) Proposed program dates Who will be the person in your department to be nominated as faculty director of this program? In the event that this person is not able to continue, who would take over this role? Has our institution run a program in this city/location in the past? Question Title * 3. Program description: Question Title * 4. Have you ever planned or worked with an educational program abroad? If yes, in what capacity? Question Title * 5. Do other programs exist at the proposed site abroad with which your proposed program could collaborate and share resources? Explain. Question Title * 6. Who are the contacts you are working with at the site abroad? Please list their names and contact information. Contact 1 Name Contact 1 Information Contact 2 Name Contact 2 Information Question Title * 7. Does this site abroad already provide housing, meals and support services, including medical facilities and risk management procedures? Yes No Question Title * 8. If yes, please describe them. Question Title * 9. If no, please describe how they would be provided. Question Title * 10. Who will be providing the classroom instruction, the Program Director or the institution abroad? Question Title * 11. What support services are you seeking from the Office of Study Abroad, International, and Domestic Programs? Question Title * 12. What are the primary objectives of this study abroad program? Question Title * 13. What are the learning outcomes for this program, if different than the goals listed above? Question Title * 14. Please type your name and the date below to confirm your submission: Printed Name Date Question Title * 15. Please print information in this form and obtain Dean signature Dean Printed Name Dean Signature Date Question Title * 16. Upload printed form signed by Dean DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Upload printed form signed by Dean Done