Fillable Travel Program Application Form WEB (Tallahassee Community College)

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Travel Program Application Form WEB (Tallahassee Community College)

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Tallahassee Community College
CREDIT INTERNATIONAL OR
DOMESTIC TRAVEL STUDY
PROGRAM PROPOSAL
1
TRAVEL APPLICATION APPROVAL PROCESS
The faculty member must complete the proposal application and submit no later
than October 15 for summer travel. The proposal must be approved and signed
by the faculty member’s dean.
The application (with the dean’s signature) is submitted to the Coordinator of the
Global Education Council.
The Coordinator submits the application to Global Education Council to review for
completeness and to assure equity among programs. Once the program is
reviewed, a recommendation will be made for approval and submittal and
approval to the Provost no later than November 15.
Marketing of the program may begin in December. Set up an agency account for
student travel if warranted.
Provide the dean with all of the student forms no later than May 15, which
includes student code of conduct, emergency information sheet, health insurance
verification form, contact information sheet, student application, agreement of
participation, and scholarship application.
2
CREDIT INTERNATIONAL OR DOMESTIC TRAVEL STUDY PROGRAM PROPOSAL
Name of Travel Study Program
PART 1: PROGRAM LEADER INFORMATION AND EXPERIENCE
Name of Lead Faculty
Is the Lead Faculty member the instructor of record whose credentials meet the specifications
of TCC’s SACS credentials?
Yes ☐ No ☐
Is the Lead Faculty member a full time faculty member at TCC?
Yes ☐ No ☐
Has the Lead Faculty member participated in the TCC Study abroad Grant Program?
Yes ☐ No ☐
Describe the Lead Faculty member’s experiences with study abroad, international travel, the
host country language, and the proposed host country location.
3
Identify courses the Lead Faculty has taught in this area. For example, if the program
involves travel to Central America and the courses offered for credit are SPN 1120 and SPN
1121, has the Lead Faculty Member taught these courses previously?
PART 2: OTHER FACULTY/PARTICIPANTS (NOT STUDENTS)
INFORMATION AND EXPERIENCE
Names and roles of others requesting to participate in the program.
Name
Role for the Travel Study Program
4
Participant/ Faculty Name #1
Describe other participant’s experiences with study abroad, international travel, the host
country language, and the proposed host country location.
Identify courses taught in this area. For example, if the program involves travel to Central
America and the courses offered for credit are SPN 1120 and SPN 1121, has other participant
taught these courses previously?
Participant/ Faculty Name #2
Describe other participant’s experiences with study abroad, international travel, the host
country language, and the proposed host country location.
Identify courses taught in this area. For example, if the program involves travel to Central
America and the courses offered for credit are SPN 1120 and SPN 1121, has other participant
taught these courses previously?
5
PART 3: PROGRAM AND COURSE INFORMATION
Projected Number of Students
Please describe the activities and dates of activities that will be used to recruit students.
Description of Recruitment Activity
Date and Time of
Recruitment Activity
Describe type of student sought to participate in this program with regard to academic
area, demographic orientation, or field of interest.
6
Please describe the orientation activities that will address requirements of the program, such as
medical insurance, deadlines, costs, etc.
Description of Each Orientation Session (include what will be
discussed at each session)
Date and Time of Each
Orientation
What type of travel insurance with be required of the students?
Will students be required to obtain a passport? Yes ☐ No ☐
Will students be required to obtain a travel visa? Yes ☐ No ☐
Will Non-US students be required to obtain a travel visa? Yes ☐ No☐
Will students be required to obtain health inoculations? Yes ☐ No ☐
7
If there is insufficient interest by students, what is the date when the program will be
cancelled?
What is the refund policy in case of trip cancellation by the college? Please make sure
you provide details about each cost associated with the program.
8
What is the refund policy in case of trip cancellation by the student? Please make sure
you provide details about each cost associated with the program.
The initial $150.00 deposit is refundable up until March 15. All payments made after that
date are non-refundable.
What course is being offered and how many credits for each course being offered through the
program? A syllabus must be included for each course.
Course ID
Course Name
Number of
Credits
When will course be
offered? (semester, year)
9
PART 4: PROGRAM DATES AND DEADLINES
Program Start Date
Summer
Program End Date
Accepting student applications start date
February 15
Deadline to accept student applications
February 15
Accepting student’s deposit check
amount - $150.00
February 15
Deadline for Students receiving deposit refund
March 15
Accepting student’s second payment amount
$500.00
March 15
Accepting student’s second payment amount
$500.00
March 15
Accepting student’s final balance payment
May 15
PART 5: AGENCY PROVIDER AND COSTS
Quote #1
Agency Name:
Phone Number:
Address:
Contact Person:
Price of Tour:
Does the company provide faculty/staff space per number
of paying participants?
Yes ☐ No ☐
If the company provides faculty/staff space, what is the
ratio of students to faculty/staff?
Can this space be used for a student scholarship or must
the space be used only by a faculty/staff member?
Attach the tour price quote.
10
Quote #2
Agency Name:
Phone Number:
Address:
Contact Person:
Price of Tour:
Does the company provide faculty/staff space per number
of paying participants?
Yes ☐ No ☐
If the company provides faculty/staff space, what is the
ratio of students to faculty/staff?
Can this space be used for a student scholarship or must
the space be used only by a faculty/staff member?
Attach the tour price quote.
Quote #3
Agency Name:
Phone Number:
Address:
Contact Person:
Price of Tour:
Does the company provide faculty/staff space per number
of paying participants?
Yes ☐ No ☐
If the company provides faculty/staff space, what is the
ratio of students to faculty/staff?
Can this space be used for a student scholarship or must
the space be used only by a faculty/staff member?
Attach the tour price quote.
11
PART 6: SELECTION OF EDUCATION TRAVEL COMPANY
Which agency are you recommending to
handle the travel for your program?
What is the rationale regarding the recommendation? The recommendation of any agency
may reside not only on costs but also on quality of the package that the company can provide
and how well the package meets the needs of the program. An educational travel agency
must be able to work well with faculty to address academic goals, travel logistics, pertinent
college policies, safety issues particular to an academic institution, and the wellbeing of
students, faculty, and the college community.
Please attach the travel itinerary that was provided by the recommended agency.
12
PART 7: SAFETY AND EMERGENCY PREPARATION
Please explain your communication process with students in the event that something
happens to you or if you must separate yourself from the group.
Has the country been listed on the Department of State’s Travel Warning list within the last
year? If yes, please explain.
By what means will the faculty member be in contact with the college and how often will the
communication be initiated while travel takes place?
13
PART 8: BUDGET AND FUNDING
Salary expected for the lead faculty member
Identify other TCC Employees who are not the lead faculty member but who will have an
instructional/supervisory or related role and will receive a salary.
Name
Amount of Salary
What is the total salary (include lead faculty and
others)?
Will the faculty member(s) request additional funds? If yes, pleased identify these additional
costs and how they will be covered.
No
Program Expenses
Amount
Qty
Total
Faculty
Airfare
Room and Board
Meals Per Diem
Excursion & Associated
Fees
Faculty Grand Total
$
0
14
Students
Airfare
Room and Board
Excursion & Associated
Fees
Cost of Tuition
$
Personal Spending (Extra Meals or Items)
$
Student Grand Total
$
Funding Sources for Students
Source
Amount
Total
Scholarships
General funds
Other, Please explain
$
Other, Please explain
$
Other, Please explain
$
Funding Sources Grand Total
$
If you plan to use scholarships, please attach written approval from the Vice-
President of Student Affairs.
Overall Program Costs
Faculty
Students
Overall Program Cost
Cost Per Student
$
Final Cost per student less scholarship
$
$
0
0
0
0
0
15
PART 9: SIGNATURE PAGE
_____________________________________________________________ ____________________
Lead Faculty Member/ Program Leader Date
_____________________________________________________________ ____________________
Division Dean Date
_____________________________________________________________ ____________________
Global Council Faculty Coordinator Date
_____________________________________________________________ ____________________
Provost Date
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Travel Program Application Form WEB (Tallahassee Community College)

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Completed 7 September 2020

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