Request for Memorandum of Understanding
Between UMB and a Party in Another Country
Please provide the following information to support any request for a Memorandum of Understanding, or any affiliation agreement by any other name, between UMB, or a UMB School or unit, and a party in another country. A draft MOU will be prepared by the Office of Research & Development after the Request has been approved by UMB. Add attachments as necessary to provide complete answers. Use this form to request amendments, extensions of term, and supplements to existing MOUs, whether or not they have been routed to ORD.
Date: ______
Initiating Faculty Member or Administrator: ______
Requesting UMB Department/Center/Institute and School:
______
I. Information about Other Party to Requested MOU or modification of MOU:
Full Legal Name: ______
Country: ______
Legal Structure (University, Gov’t Ministry, nonprofit organization, etc):
______
If the Other Party is not government-operated, how is it supported? ______
______
Year Other Party established: ______
Other Party offers academic degree programs? Yes or No ______
If yes, what are they? Bachelor’s ______Masters ______Ph.D. ______
Offers professional degrees: Yes or No ______
If yes, what are they? ______
Briefly describe any current academic or business relationships between UMB and Other Party:
______
Contact information for the Other Party: ______
______
II. Information about the Requested MOU:
Does the requested MOU amend, supplement, supersede or extend the term of a prior MOU? Yes or No ______
If yes, please attach a copy of the relevant MOU. In the following questions, describe the updates, modifications, or other changes being made to the prior MOU.
1) Purpose of the relationship covered by the MOU (add attachments as necessary to fully explain):
Education and Training ______
Technical Assistance ______
Research or other sponsored work ______
Professional Services ______
Other (explain) ______
2) Description of existing programs and/or relationships involving UMB or any of its schools, and the Other Party:
______
______
______
3) Required attachment: What are the common goals of the parties to be covered in this MOU? Attach a description or list, including, as applicable, the roles of each party.
4) Describe UMB Resources required for the performance of any UMB responsibilities under the MOU:
Funding ______
Faculty/Personnel Effort ______
Other ______
5) Proposed start and end date for MOU: ______
III. Student and Personnel Exchanges:
Will there be any Faculty/Personnel/Student Exchanges between UMB and the Other Party?
Yes or No ______
If yes, describe exchange plans, indicating approximate numbers of exchange visitors annually, their academic or employment status, and whether the visitors will come from UMB, from the Other Party, or from both parties: ______
______
______
______
______
For proposals involving exchange visitors from UMB to other countries who are health care workers or health care students, please describe arrangements for compliance with applicable local licensing requirements in the other country: ______
______
______
______
______
For proposals involving UMB personnel traveling to other countries, describe arrangements for security, lodging, distance and local transportation, and other logistical, health, safety and welfare matters: ______
______
______
______
IV. Potential Expatriate Employment and UMB Offices Abroad:
In planning for work in the country of the other party to the MOU, do you anticipate that there will be any:
_____ expatriate employment of UMB personnel, i.e., UMB faculty or staff living in the foreign country?
_____ need to rent residential space abroad?
_____ need to rent office space or other facilities for University work abroad?
Please attach information needed to fully explain our answers to this Part IV. Attachments might include funding opportunity notices, budgets for possible grants and contracts, scope of work under collaboration agreements, etc.
Even if “yes” answers are contingent upon funding from sponsors or contracts, please provide full information.
Recommendations:Faculty Member or Administrator Initiating Request / Date
Dean or Designee / Date
Chief Enterprise and Economic Development Officer and Vice President or Designee / Date
Chief Academic and Research Officer and Senior Vice President or Designee / Date
9/21/2016
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