HomeStudy AbroadProgram Proposal Utah Tech University Program Proposal This form can be saved as a draft and edited as needed prior to submission. Program Proposal Thank you for submitting a proposal for a UT Study Abroad Program! The following items are needed to complete this form: Course ID, # Credit hours, Semester to register Department Chair & Dean email address If this is an interdisciplinary program, you will need the email address for each Department Chair & Dean if applicable. Program justification information. You will be able to upload your Emergency Contingency Plan if available. Otherwise, you will need to submit your plan to the Study Abroad Office prior to travel. Program itinerary, 3rd party agreements (if applicable) and the Emergency Contingency Plan to be uploaded to the form. The Study Abroad Office will submit all 3rd party agreements to the Office of General Counsel for approval. Budget information for Program Director and Students. International travel insurance amount will be automatically calculated based on the dates you enter for the program. Exchange rates and costs may increase between the date of this proposal and the actual time of payment. To account for any unexpected expenses, you may add a dollar amount in the “Monetary Buffer” line in the student program cost section to build this into the cost. Once the proposal is submitted, it will be emailed to the Department Chair and Dean for approval. Once approved, it will then be emailed to the Study Abroad Office for review and to obtain the final approvals. You will be notified by email when all approvals have been received. You will be notified if revisions are needed. If you have any questions, please contact the Study Abroad Office at 435-879-4714. Program Information Program / Course Title * Course ID * separate course IDs with a comma Credit Hours * 1 2 3 OtherOther Semester * Spring Summer Fall Proposed Location * Program Type * Academic Service Work-related OtherOther Program Travel Start Date * Program Travel End Date * Program Director * Director Email * Is the program director traveling with the students? * Yes No Reason for not traveling Instructor teaching class, not travelingSpecialty Faculty-Led Program (no instructor travel) Additional Faculty * Yes No Additional Faculty Faculty Name * Faculty Email * plus4 Add Faculty minus4 Remove Is this program cross-listed? * Yes No If this is an interdisciplinary program, there must be multiple faculty. If this is an interdisciplinary program, there must be multiple faculty. Department * Department Chair * Department Chair Email * College Dean's Email * Additional Departments Department Chair * Department Chair Email * College Dean's Email * plus4 Add minus4 Remove Is this program associated with a 3rd party provider (tour company or university partner)? * Yes No Third-Party Company Name * Is there a third-party agreement? * Yes No Academic Strength What academic goal or requirement does the course provide students? * How does the program fit a needed academic or geographical niche not available at Utah Tech? * Is the course part of a department and school objective, consistent with regular department curriculum? Please explain * Does the course have at least one course objective and one student outcome tied to an assessment activity? Please explain * Personal and Institutional Safety Will this program travel to multiple countries? * Yes No U.S. Territory Country * What is the current travel advisory level according to the US Department of State? * 1 2 3 4 See U.S. State Department Travel Advisory for current advisory level. Under Policy 604, Level 4 destinations will generally not be approved. Travel to Level 3 destinations should be reconsidered and must be reviewed and approved by University Risk Management. Comments Countries Country What is the current travel advisory level according to the US Department of State? * 1 2 3 4 See U.S. State Department Travel Advisory for current advisory level. Under Policy 604, Level 4 destinations will generally not be approved. Travel to Level 3 destinations should be reconsidered and must be reviewed and approved by University Risk Management. plus4 Add Country minus4 Remove How does the program avoid putting students, faculty, and Utah Tech in compromising, illegal, or unsafe situations? * How does the program avoid compromising student and faculty health? * A stated in Policy 604, a detailed contingency plan for emergencies must be submitted to the Study Abroad office prior to travel. You may upload your plan on the next page of this form; otherwise, you must submit no later than 30 days prior to travel unless requested earlier due to travel advisory level. Strategic Value How does the program meet department, school, and university strategic priorities? * Does the program have a solid in country contact? How does it build our academic reputation and connections? * Will the program run for more than one year? * Program Length Cultural and Political Sensitivity How does the program prepare students for and promote respectful and appreciative interactions with others with an understanding of the social, economic, political, historical, religious, and cultural context of their experience abroad? * Does the program avoid siding with or supporting one political faction or political view over another? * Affordability Have you explored different options to provide the highest quality program without making the trip unattainable for students? * Proposed Itinerary File Upload * Drop a file here or click to upload Choose File Maximum file size: 26.21MB Third-Party Agreement File Upload * Drop a file here or click to upload Choose File Maximum file size: 26.21MB Emergency Contingency Plan Please upload a detailed contingency plan for emergencies. File Upload Drop a file here or click to upload Choose File Maximum file size: 26.21MB Program Budget Minimum number of students * Maximum number of students * PROGRAM DIRECTOR COSTS (to be funded by student fees) Instructor Airfare Instructor Lodging Instructor Meals Travel to/from US Airport Instructor In-country Travel Instructor Activities Other Costs (please specify) Other Costs Amount * Instructor International Travel Insurance Total Program Director Cost Number of Faculty Traveling * 1 2 3 4 Number of Faculty Traveling * 1 2 3 4 Number of Faculty Traveling * 1 2 3 4 Number of Faculty Traveling * 1 2 3 4 Total Cost for Multiple Faculty Total Cost for Multiple Faculty Grand Total Program Director Cost Cost Per Student International Lodging International Activities International Meals In-country Travel Other (please add description) Other Costs * Monetary Buffer Enter a dollar amount to be added to the student cost to cover unexpected expenses and any fluctuation in the exchange rate. If no buffer is needed, enter “0” Student International Travel Insurance Program Director Cost (director cost/min # students) Cost for Multiple Faculty (faculty cost/min # students) Cost for Multiple Faculty (faculty cost/min # students) Total Program Cost Per Student ESTIMATED PERSONAL EXPENSES (not included in the program fee) Airfare Passport (for students who do not yet have a passport) Visa (if applicable) Meals In-country Travel Other (please add description) Other Costs * Total Personal Expenses If you are human, leave this field blank. Submit Reset Form
