Fillable FullApplicationpacketmustbesubmitted bydeadlineto:facultyledtravel@wcu.edu ChecktheIPSFacultyLedTravelPage fordeadlinedates:ips.wcu.edu (Western Carolina University)

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Faculty-Led Education Abroad New Program Proposal Form
YoumusthaveanapprovedPermissiontoPlanformbeforesubmittingthisproposalform
ContacttheFaculty‐LedrepresentationinEducationalOutreachforanyassistancewiththisform.
Submitthecompletedproposalandattachmentsviaemailtofacultyledtravel@wcu.eduandputthe
papercopywithapprovedsignaturesincampusmail.Seechecklistonpage3fordetailedlistofwhat
tosubmit.
Pleasenotethatduringthereviewprocess,additionalinformationmayberequested.
Purchasestowardsthistripmaynotbemadeuntilthetriphasbeenapproved.Youwillbe
notifiedbyInternationalProgramsafterreviewofallsubmitteddocumentation–see
checklistonpage3.
Program
Name
Countries
Duration Departure Return TotalDays
PermissiontoPlan–DateofApproval
Term/yearprogramwillbeoffered
Datesforcourse(ifdifferentfromtravel)
HastheUSStateDepartmentThreatLevel
changedsinceyourpermissiontoplanwas
submitted?Issoexplain.
FullApplicationpacketmustbesubmitted
bydeadlineto:facultyledtravel@wcu.edu
ChecktheIPSFacultyLedTravelPage
fordeadlinedates:ips.wcu.edu
NewProposalForm–Updated2/26/2020 2
TableofContents
SubmissionChecklist.................................................................................3
Instructors.................................................................................................4
Course/Credit............................................................................................6
UnofficialTravelers...................................................................................8
LogisticalArrangements
........................................................................................8
3
rd
PartyProvider........................................................................................8
Lodging........................................................................................................9
ClassroomSpace.........................................................................................9
MealArrangements.................................................................................10
Transportation..........................................................................................10
Air...............................................................................................................................10
In‐Country...................................................................................................................11
Safety........................................................................................................12
Health&MedicalAccess...........................................................................13
Approvals
................................................................................................................16
NewProposalForm–Updated2/26/2020 3
SubmissionChecklist
HardCopySubmissionChecklist
–
allitemsarerequired
NewProposalForm(required)
Budget(required)
Itinerary(required)
Syllabuswithformalandinformalcontacthours,prerequisites,&GlobalLearningOutcomes
(required)
ChromeRiverApproval–pulldownaPDFofyourtrip’scompletedapproval(required)
ApprovalSignaturesPage(required)
ElectronicCopySubmissionChecklist(emailedtoIPSatfacultyled@wcu.edu)
Saveandsendanelectroniccopyofthisproposalform(required;noscansplease)
BudgetinExcelformat(required;noscansplease)
Scansofallotherdocumentsfromhardcopylistabove(required)
NewProposalForm–Updated2/26/2020 4
InstructorBiographicalInformationandQualifications
Instructor
Last First
Email
WCU Other
Phone
Office Cell
College
College Department
Emergency
Contact
Name/Relationship Phone
Describeyourinternationaltravelandteachingexperiencewithstudentgroups.
Describeyourtravelexperienceintheproposedprogramlocation(s).Ifyouhavenoexperiencein
the
location,pleaseindicatehowyouwillacquiretherelevantinformationtosucceedboth
academicallyandlogisticallyforthisprogram.Iftravelingtoanon‐Englishspeakingcountryorarea,
pleaseincludeyourleveloffluencywiththelocallanguage.
NewProposalForm–Updated2/26/2020 5
2
nd
InstructorBiographicalInformationandQualifications
Ifno2
nd
instructor,skiptonextpage.
2
nd
Instructor
Last First
email
WCU Other
Phone
Office Cell
College
College Department
Emergency
contact(optional)
Name/Relationship Phone
Describeyourinternationaltravelandteachingexperiencewithstudentgroups.
Describeyourtravelexperienceintheproposedprogramlocation(s).Ifyouhavenoexperiencein
the
location,pleaseindicatehowyouwillacquiretherelevantinformationtosucceedboth
academicallyandlogisticallyforthisprogram.Iftravelingtoanon‐Englishspeakingcountryorarea,
pleaseincludeyourleveloffluencywiththelocallanguage.
NewProposalForm–Updated2/26/2020 6
Course&CreditInformation
•
FormalContactHours:Eachcredithourrequiredmustinclude15hoursofformalinstructional
contact,andapproximately30hoursofinformalclass/studytime.
Tripswithcoursesenrollingbothundergraduateandgraduatestudents:Besuretoinclude
a
singlesyllabusthatdocumentsincreasedexpectationsforgraduatestudentsortwosyllabi,
includingonthegraduatesyllabusaclearindicationoftheincreasedexpectationsfor
graduatestudents.
ServiceLearningCourses‐Faculty‐Ledprogramswithaservice‐learningcomponentmay
qualifyasservicelearningcredit.PleasesubmittherequiredpaperworktoDr.Perry.
Areyouplanningonenrollingstudentsatand/orcollaboratingwithaforeignhostinstitution?
YesNo
Ifyes,includeinstitutionname:
___________________________________________________________
DoesthehostinstitutionhaveanagreementwithWCU?
YesNo
Pleasedescribethenatureofyourarrangementwiththehostinstitution:
Checkallcomponentsthatapplytoyourcoursebelowandprovideabriefdescription:
Community
Service
CivicEngagement
Researchwith
HumanorAnimal
Subjects
NewProposalForm–Updated2/26/2020 7
Coursesyllabusmustcontain:
GraduateorUndergraduate
CourseName,PrefixandNumber
CreditHours
ContactHours(FormalandInformal)
Requiredformajor,studyabroad,minor
Prerequisitesincludinglanguagerequirements
GlobalLearningObjectives
Itinerary
Pleaseattachadetaileditinerarydescribingtheprogramofactivities,opportunitiesforlanguageand/or
cross‐cultural
immersion,sideexcursionsrelatedtothecourse,visitstorelevantin‐countryinstitutions
and
organizations.
Ifyouhavesomeonein‐countrywhowillbe
assistingwitharrangements,
pleasedescribe
theirqualifications.Providecontact
informationforthisindividual.
Ifyoudonothavea2
nd
instructor,please
explainwhowillassistinemergencies.
NewProposalForm–Updated2/26/2020 8
UnofficialTravelers
Allunofficialtravelersmustpayairfare,anypercapitacostsforfood,lodging,plusanyprogramming
costsincurred.Anyunofficialtravelerwillbeenrolledinanon‐creditcourseandmustpaytheresulting
insurance.Aspouseordependentoftheprogramleaderorassociate(s)isconsideredanunofficial
traveleraffiliatedwithWesternCarolinaUniversity.AnyoneNOTaffiliatedwithWCUmustfillout
additionalpaperwork.
Namesofallunofficialtravelers AffiliatedwithWCU
Yes No
Yes No
Yes No
Yes No
LogisticalArrangements
3
rd
PartyProvider
Ifapplicable,providethenamesandwebpagesofallvendorsthatwillcoordinatein‐country
arrangements.NotethatallcontractswithvendorsmustbesignedandapprovedbytheUniversity
administration(typicallyChancellor’ssignatureisrequired).Pleaseprovideblank3
rd
partycontract
tobevettedbylegal.
Important:alllodgingotherthanhotelsmayrequireadditionalapproval.PleasecontactOIEDfor
additionalinformationpriortosubmittingproposal.
Ifapplicable,includetheuseoftheWCUAAAaccountforflights.
3
rd
Party Webpage Responsibilities
e.g.Lladro https://www.lladro.com/en_us ProvidingEducationalTour
NewProposalForm–Updated2/26/2020 9
Lodging
Checkallthatapplyandprovideabriefdescriptionofarrangements.Datesateachlocationshouldbeon
itinerary.
Hotel
Hostel
Student
Residence
Homestay
Includevetting
process
Other
(MustDescribe)
ClassroomSpace
Describeclassroomorotherteachingvenues.
NewProposalForm–Updated2/26/2020 10
MealArrangements
Pleaseincludeinformationregardingstudentmealsduringthetrip.
TotalnumberofmealsfromDeparturetoReturn
Numberofmealsincludedin
studentpayment
Numberofsharedmealsprepaid
orpaidbyinstructor
Numberofmealswithper‐diem
providedtostudent
Numberofmealsnotincludedinpayment–thisshouldbelistedin
thebudgetunderstudentresponsibilities
Transportation
AirTransportation
Indicatewhetheronthistrip,thegroupwilltraveltogetherorifstudentsareexpectedtomaketheir
ownarrangementsandprovidedetailsbelowperyourselection:
GroupTravel StudentsArrangeOwnTravel
GroupTravel
Indicatehow
thiswillbe
arranged:
E.g.WilcoxTravelCompany/AAA/etc.
HowIncludedin
Budget
ListedinStudentResponsibilityListedinCourseFees
DepartureCity
WhereProgram
BeginsandEnds
E.g.Cullowhee,NC
ListIntermediary
Flights(City,
CountrytoCity,
Country)
E.g.Departure‐AshevilletoCharlotte,NC|Return–Atlanta,GAtoAsheville,NC
OverseasArrival
City
E.g.Stuttgart,Germany
Overseas
DepartureCity
E.g.Stuttgart,Germany
NewProposalForm–Updated2/26/2020 11
StudentsArrangeOwnTravel
HowIncludedin
Budget
ListedinStudentResponsibilityListedinCourseFees
Indicatehowstudent’stransportationwillbetrackedandsafetyensured.
i.e.Instructorwillkeepspreadsheetofstudent’stransportation.Instructorwillmeetstudentsat
airportorwillfollowupwithstudentuponarrivalofmeetingpointdestination.
In‐CountryTransportation
Describein‐countrytransportationandhowthisisbudgeted.IfdepartureisCullowhee,then
transportationtoandfromthedepartureairportmustbeincluded.
Metro
Train
Bus
Taxi
Other/Private
Transportation
TravelingtoMultipleCountries:
Iftravelingtomultiplecountriesonthistrip,pleaseindicatemethodoftransportation.
NewProposalForm–Updated2/26/2020 12
Safety
SafetyProcedures
Describetheprocedureforhandlingstudentillness,injury,oremergencies.Also,describethe
procedureforhandlingstudentmisconductanddismissalfromthetrip.
ContactInternationalProgramsforexamples.
SafetyofLocation(s),Housing,andMeals
Describeanypotentialsecurity/safetyconcernsaboutthecountries/towns/generallocations
proposedforyourprogram,groupmeals,cleanwaterorlivingarrangements.
Also,discussanylocationsneartheprogramsitethatareconsideredunsafeandwherestudentswill
notbeallowedtogo.Ifusinghomestays,pleaseelaborateonhowthesearevetted(begunonpg.9)
NewProposalForm–Updated2/26/2020 13
SafetyofTransportation
Ifstudentsarearrivingindependentlyto/fromtheinternationalairport,addresshowyouwillplanto
handledifferingarrivalsandtheirsafetraveltotheprogramsite.Ifstudentsareleavingfromcampus
describethetransportationtothedepartureairport.
Checkallthatapply,anddescribelevelofsafetyandsafeguardsinplaceforeach.
Public
Transportation
TrainTaxiMetro,
etc.
Chartered
Buses/Vans
Vehiclesdrivenby
WCUEmployees
requiresspecial
permission*
ExtendedTravel
onFoot
DrivinginCountriesOutsideoftheUS
*DoyouplanforanyWCUemployeestodrive?Youwillneedtocheckthedrivingrequirementsin
countryandrequestapriorapprovalthroughOIEDbysubmittingaphotocopyofthedrivinglicense(s)
tobecheckedbyUniversityPoliceatleastthreemonthspriortodeparture.Studentsarenotallowed
todriveunlesstheyarealsoemployeesofWCUandtheirdrivingrecordshavebeenchecked.
WCUAffiliate IndicateFaculty,StafforStudent
NewProposalForm–Updated2/26/2020 14
HealthandMedicalAccess
Youmustalsoconsultthefollowingwebsitesforadditionalhealthinformation:
•
CentersforDiseaseControlandPrevention(wwwnc.cdc.gov/travel/destinations/list/)
•
U.S.StateDepartment(travel.state.gov)
•
WorldHealthOrganization(www.who.int/countries/en/)
Site‐RelatedMedicalIssues:Pleasespecifyanyimmunizationrequirementsandhealthconcerns
relatedtoyourprogramsite(s),andhowyouplantoaddressthem.Itisimportanttodistinguish
medicalrequirementsfrommedicalrecommendationsandtocommunicatethatdifferencetothe
students.Itisimportanttoreflectintheprogrambudgetthecostforhealthpreparationandto
communicatetothestudentsinwritingthatthiswillbeanout‐of‐pocketexpensenotincludedinthe
programcost.
StudentMedicalFitness:Arethereanyspecificfitnessrequirementsyourstudentsneedtomeet
for
successfullycompletingyourprogram?Ifso,whatmeasureshaveyoutakentoensurethatthe
studentsmeetthoserequirements(healthforms,
etc.)?
NewProposalForm–Updated2/26/2020 15
MedicalFacilities:Describethetypes,location(s)andqualityofmedicalfacilitiesnearyour
program
site(s).OnceourofficehasenrolledalltheprogramparticipantsintheHTHWorldwide
healthinsuranceplan,youandthestudentswillbeabletolocateEnglish‐speakingmedicalstaff
andfacilitieslinkedtotheplan.
SiteSpecificIssues:
Ifstudentswillbeexposedtobloodorbodilyfluids,describetheprecautions.Ifstudentswillbe
workinginthefieldwithexposuretoanimals,describetheseprecautions.Ifthesitehasspecificareas
ofconcern,addressthesebelow.
Approvals
FORTHEPROGRAMLEADER
MysignaturebelowindicatesthatIagreetoabidebyuniversityandtravelpoliciesandtheregulationsand
proceduresof
InternationalProgramsandServices(Visitips.wcu.eduformoreinformation).
NameofLeadInstructor:
Pleaseprint
SignatureofLeadInstructor:
Date:
FORTHEDEPARTMENTCHAIR(S)ANDCOLLEGEDEAN(S)
MysignaturebelowindicatesthatIapprovethisinternationalexperienceandtraveldatesandcertifythat
theassociated
academiccourseshaveappropriategoals,objectives,andacademiccontentandareofferedat
the
appropriatelevel. Inaddition,theinstructorofrecordisqualifiedtoteachthecontentandtheprogram
instructorand/orco‐instructorisqualifiedtosupervisethestudentswhiletraveling.
NameofDepartmentHead(s):
Pleaseprint
Signature(s)ofDepartment
Head(s):
Date:
NameofCollegeDean(s):
Pleaseprint
SignatureofCollegeDean(s):
Date:
NextSteps:
Pleasesendalldocumentsonthechecklist(page3)toInternationalProgramsforreview.
DocumentationwillbesentbyIPStotheProvost’sofficeforfinalapproval.
Provost
Ihavereviewedtheapplicationandsupportingdocumentsandmakethefollowingdecision:
Approved:
SignatureoftheProvost:
Date:
YES NO
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FullApplicationpacketmustbesubmitted bydeadlineto:facultyledtravel@wcu.edu ChecktheIPSFacultyLedTravelPage fordeadlinedates:ips.wcu.edu (Western Carolina University)

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Completed 1 September 2020

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