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

Area CodePhone 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 Days7-10 Days10-14 DaysOver 14 Days
Number of Participants:

4-67-910-1213 or more
Time of Year

Fall SemesterJanuary TermWinter BreakSpring BreakSpring SemesterMay/Early SummerMid-SummerLate Summer
Trip Budget:

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

LodgingMealsAir TravelTravel/Health InsuranceFaculty Cell/SIM CardGuide/Program Leader/InstructorLeisure 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. AfricaSpainPortugalCubaEcuadorZanzibarMoroccoBrazilTaiwanJapanGreeceRussiaTurkeyGalapagos IslandsLebanonIndonesiaNepalDominican RepublicHaitiPuerto RicoColombiaArgentinaChilePeruMexicoCosta RicaUruguayIsrael/PalestineOther
Dates and Timing
Program Start Date

MonthDayYear
Date
Program End Date

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

MonthDayYear
Date
Has this program already been approved by your institution? (if applicable)

YesNoNot applicable
Will this be an annually recurring program?

YesNoUnsure
Are the student fees covering the faculty costs?

YesNoOther
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?

YesNo
If so, what are those activities or excursions?
Will students be receiving academic credit for this program?

YesNo
If so, how many credits?
Is this program linked to an on-campus course?

YesNo
If so, please attach a course description.

Browse Files

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

YesNo
If so, please list faculty.
Is classroom or meeting space required?

YesNoUnsure
Lodging & Meals
Which options would be considered for faculty lodging?

Hotel/B&BDormitoryHomestayHostelFurnished 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&BDormitoryHomestayHostelFurnished 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 occupancyDouble occupancyTriple occupancyNo 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?

YesNo
If so, please provide more information.
Will students who are of legal drinking age in the host country be prohibited from drinking alcohol?

YesNoOther
Transportation
Would you like Diversity Global to include international airfare (from a major US airport) and airport transportation?

YesNo
If not, how will the group be arriving?

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

YesNo
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)Other
Anything else we should know?
Anything else?
Should be Empty:

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?