DISTINGUISHED VISITORAPPLICATION
University of St. Thomas
Center for Faculty Development

Submitelectronically to the Faculty Development Center ().

Name:UST ID number:

Department:College/School:

Email:Campus mailbox:Submission Date:

Faculty status: _Full Prof_ Assoc. Prof_ Asst. Prof_ Clinical_ Adjunct

Tenure status: _ Tenured_ On tenure track_ Not applicable_ Other: ______

Date of Initial Tenure-track appointment at UST (if applicable):

Academic year of proposed work (Semester & Year):

Please answer the following questions:

1. Name and affiliation of proposed Distinguished Visitor:

2. What makes this person worthy of being brought to campus as a Distinguished Visitor? Remember that people who are well known within a discipline can be relatively unknown outside the discipline. Attach a curriculum vitae for the proposed visitor.

3. Dates of the visit:

4. Purpose of the visit?

5. Provide a schedule for the visit. (this may be in tabular or narrative form). For each event on the schedule, describe the (a)nature of the event itself, (b)topic to be addressed, and (c)who will be invited.

6. What type of advertising will be done to make the visitor’s activities known to relevant constituencies, and to the UST community at large?

7. Since Distinguished Visitors are expected to have a broad, interdisciplinary appeal to the University faculty, and other constituencies, we require co-sponsorship (by a unit outside of the unit making application) of each visit. Such co-sponsorship is most often demonstrated through contribution to the expenses of the visit but may also be demonstrated through direct participation in the programming of the visit (e.g. the schedule might include a visit to a class in the co-sponsor’s Department.; a breakfast meeting with the co-sponsoring program’s faculty; a multidisciplinary reading group in anticipation of the visit that is organized by a co-sponsor, etc.. Advertising to campus faculty at large is not considered co-sponsorship.
List the Department/program(s) that will co-sponsor this Visitor and for each describe in what tangible way(s) they will be participating in this visit:

8. When was the last time that your Department/Program was awarded a Distinguished Visitor grant? ______

9. Complete the budget form below.

Budget for Distinguished Visitor Application

1. Total expected budget for this visit: ______

2. Complete the following table. List the individual expense items (e.g. airfare, honoraria, lodging, advertising, dinner seminar, luncheon) included in this budget and give an estimate for the total amount needed for each expense item, the source of funding for that item and the amount of funding provided by that source (Add more rows to the table if needed)

Item / Total amount needed ($) / Source of funding / Amt. funding provided by source ($)

3. Total amount requested from Faculty Development: ______
(Reminder: The amount requested from Faculty Development may not exceed $1000 or 75% of the total budget, whichever is smaller.)

Revised Form (7/20/12)