Office of International Education

Please fill in the form:

Application for International Scholar-in-Residence Program

Required Fields are marked with: **

Proposal Originator Name**
Proposal Originator Department/Student Organization**
Proposal Originator Email Address**
Proposal Originator Telephone Number**

Proposal Originator Mailing Address
Street Address**
Street Address Line 2
City**
State/Province**
Zip/Post Code**
Name of Visiting Scholar as it appears on his/her passport (Immigration Requirement)**
Visiting Scholar’s Content Area of Expertise**
Visiting Scholar’s Country of Citizenship (Immigration Requirement)**

Visiting Scholar Mailing Address (Immigration Requirement)
Street Address**
Street Address Line 2
City**
State/Province
Zip/PostCode**
Country**

The Visiting Scholar’s Permanent Home Address (Immigration Requirement)
Street Address**
Street Address Line 2
City**
State/Province
Zip/PostCode
Country**

Visiting Scholar’s Date of Birth** (Immigration Requirement)
Visiting Scholar’s Country of Birth ** (Immigration Requirement)
Visiting Scholar’s City of Birth ** (Immigration Requirement)

Does the Visiting Scholar speak and understand the English Language?**

Yes No

If no, what arrangements will be made to assist in communication?

Please use the space below to compose a narrative detailing the proposed visitor activities, attest to the scholar’s qualifications, and explain how the visit would be beneficial to the campus community.

Please enter proposed dollar amounts in the in the fields below

Airfare
Ground Transportation
Meals
Honorarium
Temporary Insurance Coverage (The Office of International Education can provide quotes)
Visa Fees (The Office of International Education can provide current visa charges)
Supplies (duplicating, books, presentation materials, etc.)
Rental Fees (e.g. use of the Weidner Center)
Reception Expenses
Other

Please list any expenses categorized as “other” in the field below

International Education

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Please fill in the form:

Application for International Scholar-in-Residence Program