Off-Campus Short Term Course Proposal Form

Lead Instructor*
Department/Program*
Second Instructor / Staff

Any staff joining a course needs to secure permission from their supervisor.
Department/Program
On-Site Partner (contact info):*

Study abroad partners - please meet with Darren Gallant for a list of suggestions.
Course Title:*
Is this a new course?

If this is a new course, you must also submit the course to the Curriculum Review Committee.
Course number (if known)
Location(s) and dates off-campus*
Safety and Risk Assessment*
Please review the US State Department Travel Advisory for your intended travel location/s: https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/ Share the Travel Advisory Level here and please indicate how you will address any health, safety, and risk concerns related to traveling with a group of students to this location.
Total Days Off Campus:*
Enrollment Target:*
Number of faculty instructors:*
Total cost, incl. group travel (Exclude faculty costs)*
Cost per student (Total divided by # of students)*
Faculty costs (Airfare, housing, food)*
Project Statement*
Max. file size: 10 MB.
Tentative Itinerary*
Max. file size: 10 MB.
Budget Proposal*
Please submit the Off-Campus Short Term Budget Worksheet used to generate your proposed budget.
Max. file size: 10 MB.
Draft Course Syllabus*
Max. file size: 10 MB.
Approvals*
Max. file size: 10 MB.
Email
This field is for validation purposes and should be left unchanged.