Visiting Scholar Personal Interest Form
Western Carolina University
Office of International Programs & Services
Date: ______________________________ Male
Name: _______________ ___________________ ______________________
(First) (Middle) (Last)
International Scholar From _______________________________________________
(City & Country)
Position, title or occupation in home country _______________________________
Name and address of institution, agency or organization that you are affiliated within
your home country?
To be accompanied by family?
YES - if Yes, how many accompanying dependents? __________________
Duration of Stay at WCU From (month) ___________ (day) ______________ (Year)
To (month) ___________ (day) ______________(Year)
What do you plan to have as your primary activity at WCU?
What is your academic area of interest? ________________________________________
To which department at WCU are you applying? _________________________________