International Agreement Review Sheet

The Office of International Affairs (OIA) is charged with reviewing proposed international academic agreements, including MOUs, to ensure compliance with UCSan Diegopolicies and standards. The International Agreement Review Sheet is used by OIA to obtain basic information on the proposed collaboration, to facilitate the review process, and ensure appropriate approvals. After reviewing the Guidelines on the International Agreement Development Process, please:1)complete this form electronically; 2)obtain signatures; and 3)emaila pdf of the signed form to International Affairs Director Michelle Hermas:.

PART I: Responsible UCSan Diego Faculty*

Name/title: / Department:

*A faculty member must serve as the primary responsible party for the agreement. Refer to the Guidelines on the International Agreement Development Process for additional information on faculty responsibilities.

Additional UCSan Diegocontactsrelevant to the agreement (if applicable)

Name/title: / Department:

PART II: About the Proposed Collaboration

Partner institution:
Partner contact name and title:
Department:
Email:
  1. Describe prior or current collaborative activities, if relevant.

  1. List objectives for the proposed
collaboration. If students will be exchanged, discuss level (undergrad/graduate), purpose, and whether students are proposed to enroll in courses for credit (see Guidelines for limitations on visiting student exchanges).
  1. State whether the agreement will be campuswide, or list each UCSan Diegodivision, school or research unit to be named in the agreement. Leadership from each will need to confirm support in writing.

  1. Describe financial commitments. Include information on the potential use of external funding to support the collaboration.

  1. Describe anticipated shipping/receiving of specimens, equipment, software or goods. Import or export licenses may be required. Contact Export Control () for a license review to ensure the required authorizations are in place prior to shipment.

  1. Agreement duration (typically 3 - 5 years):

  1. Desired approximate signing date:

PART III: Signatures

Proposals involving academic units require routing through the department chair, MSOand division dean. Proposals involving ORUs require routing through the ORU director and MSO. After discussing the completed Review Sheet with the appropriate individuals, have each individual sign below where indicated. If an individual is not available to sign, they may send a brief email to Michelle Hermas[] confirming support for the proposal.

Faculty Representative:Your signature below verifies that you have reviewed the Guidelines on the International Agreement Development Process and agree to serve as the faculty representative for the proposed collaboration.

______

Signature Date

MSO or Other Financial Officer:Your signature below verifies that you support the proposed collaboration.

______

Signature Date

Department Chair or ORU Director:Your signature below verifies that you support the proposed collaboration.

______

Signature Date

Division Dean (if relevant):Your signature below verifies that you support the proposed collaboration.

______

Signature Date

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