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Short-term Travel Study Abroad Program Proposal Southern Virginia University

Thank you for your interest in leading a Southern Virginia Travel Study abroad program. Please submit your proposal to Travel Study via email by February 15. Proposals will be reviewed by the Director of Travel Study and then submitted to the Provost for approval.

I.  General Information

A. General Information
Is this a REPEAT program proposal or a NEW program proposal? Repeat or New
Program Name / Click here to enter text.
Program Director/s / First Program Director / Second Program Director
Names / Last Name / First Name / Last Name / First Name
Phone Numbers / Office / Cell / Office / Cell
Email address / Click here to enter text. / Click here to enter text.
Proposed Destination / Country / Countries
Academic Term and Year
Duration/Dates / Number of Weeks: Click here to enter text. / Approximate Dates: Click to enter text.
B. Program Description
Please include a brief description of the program and its academic goals. Explain the course content and rationale for linking course content to the site abroad.
Click here to enter text.
C. COURSE INFORMATION
Will students enroll at a foreign institution on site? Yes or No
If yes; please provide name(s) of host institution(s)
Do you think you may use a vendor or travel company to facilitate in-country logistics? Yes or No
If yes; please provide name of proposed company*
*Please note that all contracts with vendors need to be reviewed, signed and approved by the Director of Travel Study and the Provost.
Course (s) offerings being considered for Travel Study:
Course title / Course
Number / Credit
Hours / Required
Course? (Y/N) / Instructor
Click here to enter text. / # / # / Y/N / Instructor
Click here to enter text. / # / # / Y/N / Instructor
Click here to enter text. / # / # / Y/N / Instructor
Click here to enter text. / # / # / Y/N / Instructor
Is there a language requirement for this program? Yes or No
If yes, What Language? Click here to enter text.
Is there a research, community service, internship, or service-learning component associated with this program?
Yes or No
If yes please describe

II. PERSONNEL QUALIFICATIONS

A. PROGRAM DIRECTOR QUALIFICATIONS (Please provide only if you are a new program leader)
Describe your personal international travel experience as well as any travel / teaching experience with student groups. Click here to enter text.
Describe your travel experience in the proposed program location(s).
Click here to enter text.
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?
Click here to enter text.

III. PROGRAM VIABILITY

A. ENROLLMENT INFORMATION
Number of students: / Optimum:
Click here to enter text. / Minimum:
Click here to enter text. / Maximum:
Click here to enter text.
.
B. PROGRAM LOCATION SAFETY ASSESSMENT
I have checked the U.S. Department of State’s website section “International Travel” for security/safety concerns regarding the proposed destination(s) at the web address http://travel.state.gov/index.html.
Yes or No
Is any program location under a State Department issued Travel Warning? Yes or No
C. Medical Issues
Are there any immunization requirements and health concerns related to your program site(s)? Yes or No
If yes please explain. Click here to enter text.
I have checked U.S. Department of State’s website for potential health issues at http://travel.state.gov/index.html as well as website section “Travelers’ Health” of the Centers for Disease Control and Prevention at http://www.cdc.gov.travel Yes or No

IV. DURATION AND ITINERARY

A. ITINERARY
Although your itinerary may still be a work in progress, please give a general outline of your plans here.

V. Program Budget

A.  PROGRAM BUDGET
If this is a repeat program, do you plan to use the same budget you used previously? Yes or No
If this is a new program or a repeat program with significant budgetary changes, have you met with the Director of Travel Study to create a preliminary budget? Yes or No
I have attached a budget worksheet with this form. Yes or No

VI. Approvals

Faculty Member/ Program Director
If the program is approved, I agree to abide by the regulations and procedures as described in the Travel Study Program Director Handbook.
Name of Program Director: / Click here to enter text.
Date: / Click here to enter text.
Travel Study Director (for office use only)
I have checked and approved the budget, travel and safety to ensure compliance with our standards
Yes or No
Name
Date
PROVOST (for office use only)
I have checked and approved the course offerings, budget, travel and safety to ensure compliance with our
standards Yes or No
Name
Date