For office use only
UMKC Group Study
Abroad Program Approval Form
New Program: (check one)
Yes
Electronic copy submitted
Copy of proposal forwarded
Final report submitted
(if offered previously)
Required Signatures
No
Dean
Department Chair
Departmental Contact
Person for Course Offerings
Budget tables
Program Title:
Country/Location:
Approved
Not approved
Decision pending
Amount of funds awarded
Comments:
Sponsoring
Department(s):
Faculty Program
Director:
Faculty of Record (if different from Faculty Program
Director):
Brief Program Description and
Subject Areas (e.g., Journalism):
(For IAP’s Globetrotter database of
programs. No more than 50 words,
please)
Fall
Semester Offered:(check one)
Students must be registered for the same session
in which they travel.
Departure Date:
Winter Break (Please
indicate semester credits
will be awarded)
Winter/Spring
Spring Break
Summer
Return Date:
Student Application Deadline (for
Language of Instruction (for
Amount of Funds Requested
from IAB:
Other Sources of Funding
IAP website):
IAP website):
(including carry-over from
previous year):
Signatures:
Date
Department Chair approval
Date
Dean approval
Date
Faculty Program Director
Department Chair approval
Date
Dean approval
Date
Department Chair approval
Date
Dean approval
Date
Additional signatures (if
more than one department
involved): Department
Department
Submission information: Submit ONE PAPER COPY of the proposal with ALL SIGNATURES and ONE ELETRONIC COPY (no
signatures needed) to: IAP Executive Staff Assistant, international@umkc.edu, International Academic Programs,
Student Success Center #120, 5000 Holmes Road, Kansas City, MO 64110
Deadlines: October 1 (Summer programs), January 1 (Fall and Academic Year programs), May 1 (Winter/Spring programs)
Study Abroad Course Offering Form
Please Remember! If you will need a classroom on campus, you must also submit a copy of this
form to Room Scheduling, General Services Building.
It is crucial that the information on this form be accurate to ensure that your students are registered properly. The study
abroad tuition aid cannot be applied for students not properly registered.
Assigned
by IAP.
Leave
blank.
Department
Course
Number
Credits
Section
If no classroom
needed on campus,
leave blank.
Maximum
Enrollment
Semester in
which credits
will be awarded
FS-WS-SS &
Year
Instructor Name (or
name of faculty
assigning grades)
Instructor
ID
Suggested
Room
Class
Time
Comments:
Departmental Contact Person for Course Offerings *
Department
Date
Additional Departmental Contact Person for Course Offerings
Department
Date
Approval:
Additional
Signatures:
* If more than one department involved, contact person for course offerings from ALL departments must approve. IAP will forward this form to the Registrar’s
Office after the program is approved.
Detailed Program Information
Appointment, qualifications, and international experiences (C.V.
may be attached):
Program Director:
Department:
Office address:
Phone:
e-mail:
Appointment, qualifications, and international experiences (C.V.
may be attached):
Co- or Assistant
Program Director:
Department:
Office address:
Phone:
e-mail:
Rationale:
Program goal(s):
Learning objectives:
At the end of the program, students will:
Goals and Objectives
Program goal(s):
Learning objectives:
At the end of the program, students will:
Program prerequisites
and criteria for student
selection:
Grading system:
3
Marketing and Advertising
Methods used to market and advertise the program:
Anticipated number of participants:
UMKC students:
Non-UMKC students:*
* If recruiting outside UMKC, remember that all participants must register at UMKC before taking part in an UMKC study abroad program.
Students may register as non-degree seeking (or Visiting) students. Applications can be downloaded from the Admissions Office Web
page. There is no application fee for non-degree admission.
Do you expect the program to be offered again?
Yes:
No:
Student Preparation
**Program specific predeparture orientation (if
separate course):
Course number:
Section:
Credits:
Semester Offered:
** Program specific predeparture orientation is required of all students but need not be offered for credit.
Tentative list of topics to be covered during the predeparture orientation and names of faculty and staff who
might be involved:
4
Proposed Travel Itinerary (submit final if approved)
Specify dates, locations, activities for each day, housing and meal arrangements, and in-country contact information
(including telephone numbers so that you can be contacted in case of emergency):
5
Study Abroad Group Program Budget
Program name:
Date budget prepared:
Projected number of students on program:
Projected # of students on program:
Program dates (departure and return):
Program Director(s)' names:
Currency of budget:
Exchange
Exchangerate
rateused:
used:
Comments:
Step 1: Calculate costs for each Program Director
Table 1 - Program Fee Expenses for Program Director
Amount
Passport (if purchasing or renewing for this program)
Visa (if needed)
Vaccinations and preventive medicines
Housing
Round-trip airfare
Round-trip airport transportation
Local ground transport (bus, subway, etc.)
Entrance fees
Meals
UMKC Purchasing Card cash advance fee
Service providers (faculty share of group meals, group transportation, etc.)
Additional expenses (specify)
Subtotal
Subtract funding from other sources
Subtract remaining funding from previous program
Total Program Director costs
Program Director costs divided by # students
enter this amount on Table
2, line 1
Note: faculty salary/benefits may not be included in program fee
6
Step 2: Calculate program fee for each student
TABLE 2 - Program Fee Expenses Per Student
Amount
Students’ share of faculty cost (from Table 1)
Housing
Round-trip airfare (if students not responsible for own transportation)
Round-trip airport transportation (shuttle bus, etc.)
Local ground transportation (bus, subway, etc.)
Entrance fees (museums, etc.)
Service providers (student share of group meals, group transportation, etc.)
Course materials
Advertising cost
Contingency fee
Existing program deficit
Total Program Fee expense per student
enter this amount on Table
5, line 1 (A and B)
Step 3: Calculate other (non-program fee) expenses for each student
TABLE 3 - Other Student Expenses (non-Program Fee)
Terra Dotta Subscription for Online Study Abroad Application and Form Submission
Amount
$25
Meals not included in Table 2
Incidentals
Books, equipment, and supplies not included in Table 2
Airfare (if not included in Table 2)
Passport
Passport mailing costs
Visa (if required)
Visa mailing costs
Vaccinations and preventive medicines
Other (please specify)
Total other (non-program fee) expenses per student
enter this amount on Table
5, line 2 (A and B)
7
Step 4: Calculate tuition and fees for each student
Table 4 - UMKC Tuition and Fees Per Student
Resident
Non-Resident
enter this amount
on Table 5, line 3,
column A
enter this amount
on Table 5, line 3,
column B
Tuition for _____ credits
Subtotal
Health Facility Fee
Student Services Fee
Student Activity Fee
Other course fees
Total
Step 5: Calculate total cost per student
Table 5 - Total Cost Per Student
Resident (A)
1. Program Fee per student (from Table 2)
2. Non-Program Fee per student (from Table 3)
3. Tuition and fees per student (from Table 4)
Total program cost per student
8
Non-Resident (B)