BAYLOR APPLICATION TO THE FACULTY FELLOWSHIP PROGRAM BIG 12 UNIVERSITIES Baylor faculty member’s name: Academic unit: Big 12 unit and university you wish to visit: Dates of visit: Checklist of items to be attached: A current curriculum vitae A brief (one-page) description of the purpose and activities of your visit Statement of how your duties will be covered in your absence Letter of invitation from the proposed Big 12 host institution department or school. Statement from your department chairperson and/or dean, indicating support for the visit and the prospective benefits of the visit for both the individual and unit. Signature of Applicant Date Funds to be Taken From: Account Department Signature of Dean Date Signature of Executive Vice President and Provost Date Applications can be submitted anytime to your respective dean, but will be reviewed on October 1, March 1, or July 1 depending upon date of submission. Rev. 11/2006 Big 12 Faculty Fellowship Application - 1