Faculty-Led/Study Abroad Questionnaire

Faculty-Led/Study Abroad Questionnaire
Completing this faculty-led program questionnaire will help us design and customize the perfect study abroad program for you, your students, and your institution. We look forward to working with you!
Your Name *

First Name Last Name
Name of School/Institution *
School/Institution
E-mail *
example@example.com
Phone Number *

Area Code Phone Number
Name of Course Leader/Faculty
Program Location
City, Country, or Region
Course/Program Title (if applicable)
Program Overview

Check as many boxes that apply.
Trip Duration:

5-7 Days 7-10 Days 10-14 Days Over 14 Days
Number of Participants:

4-6 7-9 10-12 13 or more
Time of Year

Fall Semester January Term Winter Break Spring Break Spring Semester May/Early Summer Mid-Summer Late Summer
Trip Budget:

Up to $2000 $2001-$2500 $2501-$3000 $3001-$3500 $3501-$4000 $4001-$5000 More than $5000
Desired Inclusions:

Lodging Meals Air Travel Travel/Health Insurance Faculty Cell/SIM Card Guide/Program Leader/Instructor Leisure Excursions
Where do you want to go?

Please check/list any locations (in addition to the location indicated above) of interest, if applicable.
Check as many as apply *

S. Africa Spain Portugal Cuba Ecuador Zanzibar Morocco Brazil Taiwan Japan Greece Russia Turkey Galapagos Islands Lebanon Indonesia Nepal Dominican Republic Haiti Puerto Rico Colombia Argentina Chile Peru Mexico Costa Rica Uruguay Israel/Palestine
Dates and Timing
Program Start Date

Month Day Year
Date
Program End Date

Month Day Year
Date
Are the dates flexible? If so, what are the parameters?:
More Proposal Details
When is this proposal due at your institution? (if applicable)

Month Day Year
Date
Has this program already been approved by your institution? (if applicable)

Yes No Not applicable
Will this be an annually recurring program?

Yes No Unsure
Are the student fees covering the faculty costs?

Yes No
Minimum enrollment to run the program (if applicable)
Maximum enrollment (if applicable)
What are the students' majors?
Do you have a target price in mind for this program?
Academic Content
What are your course/program objectives and what would you like students to get out of the course?
Do you have any specific activities or excursion you would like incorporated into this program?

Yes No
If so, what are those activities or excursions?
Will students be receiving academic credit for this program?

Yes No
If so, how many credits?
Is this program linked to an on-campus course?

Yes No
If so, please attach a course description.

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Will a faculty member be responsible for instruction during the program?

Yes No
If so, please list faculty.
Is classroom or meeting space required?

Yes No Unsure
Lodging & Meals
Which options would be considered for faculty lodging?

Hotel/B&B Dormitory Homestay Hostel Furnished Apartment
Among the above choices, which would be your preference for faculty lodging?
Please list specific requirements for faculty lodging, if applicable.
Which options would be considered for student lodging?

Hotel/B&B Dormitory Homestay Hostel Furnished Apartment
Among the above choices, which would be your preference for student lodging?
Please list specific requirements for student lodging, if applicable.
Is there a preference in terms of occupancy for student lodging?

Single occupancy Double occupancy Triple occupancy No preference
Our programs often include breakfast as well as at least one additional meal per day (usually late lunch/early dinner). Do you have additional meal requests, or a different preference?

Yes No
If so, please provide more information.
Will students who are of legal drinking age in the host country be prohibited from drinking alcohol?

Yes No
Transportation
Would you like Diversity Global to include international airfare (from a major US airport) and airport transportation?

Yes No
If not, how will the group be arriving?

Individually Group flight
Are there any other transportation requests?
Activities & Excursions
Would you like Diversity Global to handle all activity and excursion recommendations?

Yes No
Please select the type(s) of activity emphasis you'd like on the program.

Co-Curricular (activities designed to enhance the academic content of the program) Cultural (meant to enhance understanding of the local culture) Community Engagement (meaningful interaction with local residents or groups) Service-Learning (volunteer work in local communities) Natural and/or Leisure (excursions to local natural sites of interest and/or tourist sites) Day Trips (all-day trips to sites of interest; may encompass some other categories)
Anything else we should know?
Anything else?
Should be Empty:

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Faculty-Led/Study Abroad Questionnaire

Program Overview

Where do you want to go?

Dates and Timing

More Proposal Details

Academic Content

Lodging & Meals

Transportation

Activities & Excursions

Anything else we should know?