Application for Appointment Term -Semester: Summer /Winter
Destination:
Faculty Information
Name(s):
Mailing address:
Phone:
E-mail:
Work Phone:
CHECKLIST:
___ A. Discuss your proposal with your Mesa College Study Abroad Liason
Prof. Dora Schoenbrun-Fernandez, dschoenb@sdccd.edu, X2228
___ B. Complete this “Application for Appointment and obtain the necessary signatures
below from your Department Chair and School Dean.
___ C. Attach a 2-page resume with your application.
___ D. Attach a tentative Study Abroad itinerary provided by one of the recommended
Study Abroad Providers (http://www.sdmesa.edu/academics/study-abroad/
forms.shtml) with your application.
___ E. Submit this application to Dean Leslie Shimazaki (G-201) by March 6, 2020
(usually at least one year in advance).
- This application is true to the best of my knowledge:
Signature of applicant: _____________________________
- I recommend this instructor for this opportunity:
Signature of Department Chair: ______________________________
- I recommend this instructor for this opportunity:
Signature of School Dean: ______________________________
Final approval to lead a study abroad program will depend on funds available, approval by the Mesa College
International Education Committee, and approval by the VP of Instruction. Fill in the information below or attach
your responses separately.
Is part of a joint program ___ Yes ___No.
Name of other faculty member(s) ________________________________________________
Name: Destination / Term:
SDCCD - Faculty Study Abroad Application Rev. 12-2019
1. Attach resume:
College/University
Degree Date Granted Major Minor
2. Please list the courses you have taught in your present teaching assignment (during
the previous academic years):
1.
2.
3.
4.
3. Which course(s) do you propose to teach abroad? (must be a UC and/or CSU
transferable course)
1.
2.
3.
Name: Destination / Term:
SDCCD - Faculty Study Abroad Application Rev. 12-2019
4. Please list or attach some academic planned activities or learning outcomes while abroad.
5. How does this study abroad experience enrich student learning?
6. Describe your special qualifications, such as travel / work / educational
experience abroad.
Name: Destination / Term:
SDCCD - Faculty Study Abroad Application Rev. 12-2019
7. What is your experience working with students outside the classroom? (e.g. club
advisor, field trip/overnight travel supervisor, intercollegiate teams, etc):
8.How would you manage a crisis while directing a program abroad? Please list any training,
certifications or special qualifications that would make you better suited to handle these
type of unexpected or emergencies situations.
9. Proficient in Language of the host country of study: Yes/NO
If no, list the name for the other faculty member in this proposal _____________
the language used in the host country?
**Thank you for completing the
Study Abroad Faculty Application for Appointment**
10. Detail your plans for recruiting for this study abroad program.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome