International Delegation Visit to FIU Request Form

Delegation Contact Information

Please submit all mandatory information (marked with *)
Which entity is submitting the request? *
Salutation: *
Title/Academic Rank (if applicable):
Last Name *
First Name: *
Email *
Who was/is your primary contact at FIU [Last Name, First Name, Email Address) ?: *
Your Institution/Organization
Institution/Organization you represent: *
Country: *
City: *
Public or Private: *

Public or Private: Public Private
Founding year of institution/organization: *
Is your institution affiliated with a governmental entity? *

Is your institution affiliated with a governmental entity? Yes No
If yes, please list the affiliated organization:
Brief description of your institution/organization: *
Your Objective(s) for the Visit
Is this a first or a follow-up visit?: *

Is this a first or a follow-up visit?: First Visit Follow-up Visit
If it is a follow-up visit, when did you visit previously?: *
What is your objective for this visit?: *
Do you already have a contact at FIU? If so, please list:
Primary purpose for the visit?: *

Primary purpose for the visit?: Enhance education or research capacity of an individual department, academic unit, or the broader university Create new learning opportunities for student and/or faculty Explore new opportunities for students and/or faculty exchange Exchange knowledge and ideas around topics of mutual interest Discuss/renew potential research collaborations Learn about FIU/exploratory visit Other Other
Partnership with FIU
Do you presently have, or had in the past, a partnership with FIU? (types of partnerships: inter-institutional agreement, educational exchange, research collaboration agreement, business, or service contract): *

Do you presently have, or had in the past, a partnership with FIU? (types of partnerships: inter-institutional agreement, educational exchange, research collaboration agreement, business, or service contract): Yes No
If yes, what type?
Active when?
With which department?:
Logistics
When do you propose to visit FIU?: When do you propose to visit FIU?: * / MM / DD YYYY
If we cannot accommodate you on this date, please propose an alternate date: If we cannot accommodate you on this date, please propose an alternate date: * / MM / DD YYYY
How will you travel to FIU locally? *
Do you/your delegation members require official letters of invitation from FIU for visa purposes?: *

Do you/your delegation members require official letters of invitation from FIU for visa purposes?: Yes No
If yes, list the individual names below:
Delegation Members Information
Please provide detailed information for each member of your delegation [Last name, first name, title, rank. department, institution/organization, e-mail address, and upload biography]: *
Biographies Upload *

Attach Files

International Delegation Visit to FIU Request Form

International Delegation Visit to FIU Request Form

Delegation Contact Information

Your Institution/Organization

Your Objective(s) for the Visit

Partnership with FIU

Logistics

Delegation Members Information