Short-Term Faculty-Led Program Proposal The intent of this program ...

II. ON-SITE SUPPORT
If your course is receiving significant support from an on-site educational institution, please
identify the institution(s) and explain the nature of that support.
If the program involves a home stay experience, please describe:
a. the length of the home stay
b. the organization and/or individuals responsible for arranging the home stays
c. the standards used to determine appropriate host families
III. PROGRAM LEADER INFORMATION
You must use a 2 nd Faculty Instructor or a Support Person if your course is not receiving
assistance from an on-site educational institution that possesses its own support staff.
Exceptions to this policy must be approved by the Associate Dean for University Academic
Programs.
FACULTY INSTRUCTOR NAME AS IT APPEARS ON PASSPORT:
Department or affiliation:
Home institution:
Home address:
Home phone:
Office phone:
Fax number:
E-mail address:
Passport number:
Date passport was issued: Passport expiration date:
Date of birth:
Training and experience in subject matter (if the course topic is outside your academic
discipline, describe what training and experience you have to teach this course):
Experience in proposed location(s) and contacts you may have in the host country(ies):
Language(s) and level of proficiency:
Previous experience directing off-campus courses:
SECOND FACULTY INSTRUCTOR NAME AS IT APPEARS ON PASSPORT (if applicable):
Department or affiliation:
Home institution:
Home address:
Home phone: