Distinguished Visitors Fund Application Form - Research

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OFFICE OF THE VICE-PRESIDENT (RESEARCH)
DISTINGUISHED VISITORS FUND
2-51 South Academic Building
University of Alberta
Edmonton, Alberta, Canada T6G 2G7
T: 780.492.6378
F: 780.492.3189
vpresearch@ualberta.ca
www.research.ualberta.ca
DISTINGUISHED VISITORS FUND
Information and application form
Purpose of Fund
The fund is to support visits by individuals who are widely recognized, who have achieved a high level of
distinction in their field, and whose presence on this campus is likely to have a significant impact both for faculty
and students.
Application Information
1.
Funds will be allocated twice per year. Application deadlines are: 31 May and 31 October. Faculty
deadlines will be earlier.
2.
Ranked applications are to be submitted by a dean for visits during the current or subsequent academic
year to the Office of the Vice-President (Research). Applications should include:

Detailed program plan for the visitor

Letters of support from related departments/faculties and external community when appropriate

Visitor’s current curriculum vitae

Detailed proposed budget, following university guidelines (currently daily maximum - $45 for per diem
[meals], and $500.00 per working day for honorarium for visits up to two weeks. Honoraria for longer
visits are expected to be at lower rates)

Identify if visitor is willing to participate in ‘Town and Gown’ series

If applicable, a detailed Town and Gown program plan, benefit statement, and related budget.
3. The Town and Gown Program was set up to offer public lectures to a wider range, more general audience.
These lectures may be held on campus. The additional costs, of up to $1,000 to cover items such as
advertising, venue rental, and light refreshments may be provided if requested on the original funding
application.
4. The Distinguished Visitors Fund is not intended for guest speakers making short visits or for conference
participation. Teaching of several weeks or longer of regularly scheduled classes will not be funded.
5. Visits are to be for not less than five working days or more than three months, and are to take place during
the September-April teaching year.
6. The fund is unable to support return visits to campus of individuals previously funded under the Distinguished
Visitors Program or Distinguished Visitors Program.
7. Visitors are expected to have significant interaction with both staff and students, and expected to participate in
an ‘open’ lecture/seminar, so the wider university community can benefit from their presence on campus.
Note: For visitors participating in the ‘Town and Gown’ series, this lecture would be considered as the ‘open’
lecture.
8. Funding for off-campus activities will only be considered in exceptional cases and justification for such
requests must be included.
APPLICATION TO DISTINGUISHED VISITORS FUND
Faculty:
Department
Date:
Visitor’s name:
Visitor’s address:
Visitors first visit to U of A?
Yes / No
If no, give details of previous visits:
Visit duration:
Proposed visit dates:
Is visitor participating in Town and Gown component? If yes,
please complete page 5.
PROPOSED SOURCE(S) OF FUNDS:
Distinguished Fund: $
Other (specify):
$
Total:
$
ESTIMATED COSTS:
Travel
$
Per Diem (Meals)
$
(Days@ ) [Maximum $45.00/day]
Accommodation
$
(Days@ )
Honorarium
$
(Working days@ ) [Maximum $500.00/working day for visits up to
two weeks. Honoraria for longer visits are expected to be at lower rates]
Other (itemize w/ cost) $
Town and Gown $
(If applicable)
Name of departmental host:
Signature:
Signature:
(department chair)
(dean)
Faculty Ranking
Note: Items to accompany application:
1. One-page detailed program plan for visitor.
2. Letters of support from related departments/faculties and external community when appropriate
3. Visitor’s current CV
4. Town and Gown activity and benefit and budget (if applicable)
Applications to be received in the Office of the Vice-President (Research) by 31 May and 31 October.
Information on this form is collected directly from the visitor by the department/faculty. Therefore, this application is
not a collection tool under the Freedom of Information and Protection and Privacy Act but rather an internal
disclosure form.
Distinguished visitors Fund Application Form (November 2013)
Page 2 of 5
ON CAMPUS ACTIVITY
1.
Normally distinguished Visitors staying two weeks or less give two – five lectures/seminars for the campus
community. Please provide the details for each lecture. The Town and Gown lecture, if applicable, is
described on a separate form.
Lecture/Seminar #1
Title of lecture/seminar:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location of lecture/seminar:
Lecture/Seminar #2
Title of lecture/seminar:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location of lecture/seminar:
Lecture/Seminar #3
Title of lecture/seminar:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location of lecture/seminar:
Lecture/Seminar #4
Title of lecture/seminar:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location of lecture/seminar:
[Insert additional entries as required]
2. Visitors are expected to interact with university staff and graduate students. Interactions can take the form of
tutorials, seminars, informal work time, formal presentations, laboratory exercises, demonstrations, office
hours, etc. Please provide the following specifics of these interactions.
Interaction #1
Title of interaction:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location:
Expected outcome:
Distinguished visitors Fund Application Form (November 2013)
Page 3 of 5
ON CAMPUS ACTIVITY CONTINUED
Interaction #2
Title of interaction:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location:
Expected outcome:
Interaction #3
Title of interaction:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location:
Expected outcome:
Interaction #4
Title of interaction:
Expected audience: __________undergraduate students +__________ graduate students + __________
university staff + __________ other members of community = ____________ (total number expected).
Time and location:
Expected outcome:
[Insert additional entries – as required]
Distinguished visitors Fund Application Form (November 2013)
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TOWN AND GOWN COMPONENT (optional)
The Town and Gown program was set up to offer public lectures to a wider range, more general audience.
These lectures may be held on campus. Application may be made to cover the additional costs - up to $1,000 - to
cover items such as additional advertising, venue rental, and light refreshments.
Planned activity:
Benefit to the university and community:
Estimated costs: (maximum $1,000.00)
Advertising
$
Venue rental
$
Refreshments
$
Other (itemize)
$
Total
$
Distinguished visitors Fund Application Form (November 2013)
Page 5 of 5
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