2011-2012 CIC Woodrow Wilson Visiting Fellows Program Application Survey

1.INSTITUTION INFORMATION

Please complete the following:

Name of College/University

State

Name of President

College/University Web Address

2.CAMPUS COORDINATOR CONTACT INFORMATION - This will be the main contact person at your campus for all Woodrow Wilson Visiting Fellows information.

Please complete the following:

First and Last Name

Position/Title

Department

Email Address

Telephone Number

Fax Number

Mailing address

City, State Zip Code

3.DATE PREFERENCES

Please indicate a least three weeks in the academic year 2011-2012 when a Visiting Fellow might come to your campus.

4.NUMBER OF FELLOWS

Please indicate how many Fellows you would like to host in 2011-2012.

One

Two

One visit by a couple

Two visits by couples

Other (please specify)

5.REQUESTS FOR SPECIFIC FELLOWS

Please identify and rank order the Fellows you wish to host. CIC always attempts to assign your first choices in both Fellows and dates, but depending on scheduling and demand for particular Fellows, we sometimes must assign your second or even third choice. If you would like to have more information about particular Fellows prior to completing your application, please email visitingfellows@cic.nche.edu.

6.SPECIAL CAMPUS INTERESTS

Please tell us about college events this year that are related to the Visiting Fellows Program: for example, are there special semester themes, areas of special focus on campus, first-year experience themes, or other relevant points of emphasis?

Thank you for participating in the CIC Woodrow Wilson Visiting Fellows program and for completing this application.

To discuss your interest or a particular aspect of the Woodrow Wilson Visiting Fellows program, please email: visitingfellows@cic.nche.edu or call Michelle Friedman, program manager, at (202) 466-7230.

To submit an application, please click the "Done" button below; when you do so, the application window will close.