Please fill out the form below.
Program Name *
Last Name *
First Name *
Office Phone *
Home Phone *
Program Session *
Fall Semester Winter Break Spring Semester Spring Break Summer I Summer II
Approximate Dates of Travel *
A succinct description of the program which should include academic goals and objectives, integration of site to learning objectives, and your personal reasons for directing the program. Explain the course content for each proposed course and rationale for linking course content to the site abroad. *
Course Title *
Credit Hours *
Course Number *
Are you planning to enroll students in a host foreign institution on site? *
If yes, name of host institution
Does the host institution have an agreement with UALR?
Will you use a vendor to facilitate in-country logistics? *
If yes, please provide the name of the vendor
Are there any prerequisites to be met to participate in the program? *
If yes, please list the course prerequisites
Is there a language requirement? *
If yes, what language?
Is there a research component? *
Is there a Community Service Component? *
Is there a Service-Learning Component? *
The courses offered were approved in previous proposal documents.
The 2011 program offers new courses approved by the Department Chair.
Describe your personal international travel experience, in general, and specifically your international travel and teaching experience with student groups. *
Describe your travel experience in the proposed program location(s). *
If you have not traveled to the proposed host country, how do you plan to acquire information and ideas to maximize the potential for preparing the course material in the foreign country?
Program Associate Qualifications (if applicable)
I have checked the U.S. Department of State’s website section “International Travel” for security/safety concerns regarding the proposed destinations(s) at the web address http://travel.state.gov
Is any program location under a State Department Warning?
Does the host country have a visa requirement? *
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