Texas Woman’s University
Study Abroad Trip Information Form
Out-of-State/Country Course Brief Justification Summary
Note: This form must be submitted and the course approved before students are allowed to register for the course. This
information is required each time a trip is planned.
Attach a detailed trip itinerary and an academic content/activity explanation.
Course Information
Course Prefix:
Destination:
Course Title:
State/Country Code:
Length of Course in Number of Weeks (min. 3 weeks):
Semester Credit Hours:
Dates of Study:
Contact Hours:
Objectives of course/undergraduate student learning outcomes:
Objectives for course/graduate student learning outcomes:
Rationale for Travel:
Pre/Post travel classes held on campus (to attain minimum length standard)*:
Travel schedule and number of contact hours of instruction (attach a detailed itinerary with each city/hotel
identified)*:
*For a three credit hour course, there should be 45 contact hours of instruction excluding travel days. Courses must
cover a three-week span per THECB rules.
Clinical/Therapeutic Course – Indicate how malpractice insurance has been secured and verified for each student:
Faculty and TWU Employee Identification
Name of Trip Leader:
Title of TWU Trip Leader:
Department and College:
TWU Campus:
Date Attended Faculty Study Abroad Orientation:
Revised 11/4/2013
Name of Second Trip Leader:
Title of Second TWU Trip Leader:
Department and College:
TWU Campus:
Date Attended Faculty Study Abroad Orientation:
Student Planning
Targeted students:
Student travel orientation date:
Student travel costs including travel insurance:
Emergency Contact Information (For Travel Abroad)*
Faculty cell phone number:
Travel agency or host phone number:
Embassy/Consulate phone number for each location:
Emergency meeting place for each location:

*This information will be printed on travel cards and laminated for all participating students.
Texas Higher Education Coordinating Board
TWU Certification for New Out-of-State and Out-of-Country Courses
1. All students enrolled will meet institutional standards for admission and will be actually
admitted to the institution, or one of the participating institutions in an approved Texas
Consortium.
2. All students enrolled will pay the appropriate tuition and fees for their residency category.
Financial aid will be available to students registering in foreign classes on the same basis as for
on-campus students.
3. Instruction will be provided by faculty of the institution or a consortium institution and will be
supervised and evaluated according to institutional policies. Exception will be made only to take
advantage of uniquely qualified personnel at the out-of-state location.
4. Each course is on the approved main course inventory of the institution, is a part of an approved
degree or certification program, and is justified in terms of academic, cultural, or other
resources available at the specified location.
5. Instruction will conform to all relevant academic policies. All classes will conform to workload
and enrollment requirements, contact hour/credit ratio, and similar matters.
Revised 11/4/2013
6. Courses will not offer credit for activities undertaken primarily for travel, recreation, or
pleasure.
7. Minimum enrollments will conform to the same standards applicable were the class to be
offered on campus.
8. Multi-course offerings will meet the standards and criteria outlined in Section 3.b of the
Notification and Approval Procedures Distance Education and Off-Campus Programs and
Courses approved by the Coordinating Board (October 2005).
9. Advertising and marketing for out-of-state and foreign classes will emphasize the instructional
nature of the classes, and not create the impression that they are primarily credit-for-travel
experiences.
10. Faculty and staff will not realize unusual perquisites or financial gain for teaching out-of-state or
study abroad.
11. Free tickets for travel, accommodations, or other expenses provided by travel agents, carriers,
or hotels will be used in direct support of the instructional program and will not be used as gifts
to faculty, staff, or their families.
12. All courses offered in a shortened format will consist of the same number of contact hours,
normally 45-48, as courses offered in a regular or summer session. Students will not carry more
courses at a time in a shortened format than will give them total credit of one semester credit
hour per week of instruction. (CB Rules 4.6). Pre- or post-travel class sessions will be scheduled
to attain the required minimum length standard.
Internal Review Actions for the Course (signatures)
______________________________________
Faculty
__________________________
Date
______________________________________
Department Chair
__________________________
Date
______________________________________
Dean of College
__________________________
Date
______________________________________
Director, Teaching & Learning with Technology
__________________________
Date
______________________________________
Senior Associate Provost
__________________________
Date
______________________________________
Provost
__________________________
Date
Revised 11/4/2013
APPENDIX B
STATE CODES
Code
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
Name
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Revised 11/4/2013
Code
347
348
349
350
351
352
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
Name
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Fed. States of Micronesia
Canal Zone
Guam
Puerto Rico
Pacific Trust Territory
Virgin Islands
Marshall Islands
U.S. Dependencies (Islands)
NOTE: U.S. Dependencies includes
American Samoa, Baker Island, Howland
Island, Jarvis Island, Johnston Atoll,
Kingman Reef, Midway Islands, Navassa
Island, Northern Mariana Islands, Palmyra
Atoll, Wake Island.
Fed. States of Micronesia, and Marshall
Islands separated from the Pacific Trust
Territory. Micronesia includes Fais, Gaferut,
Kosrae, Kusaie, Mortlock, Hall, Ponape,
Pulusak, Truk, and Yap islands. Marshall
Islands includes Kili, Ralik Chain, and Ratak
Chain. Trust Territory of Pacific Islands
contains the islands of Angaur, Babelthuap,
Caroline, Helen, Kayangel, Koror, Merir,
Peleliu, Pulo Anna, Sonsorol, and Tobi.
APPENDIX B
FOREIGN COUNTRY CODES
Code
402
403
404
409
406
411
412
407
405
408
413
780
410
415
414
419
418
416
421
428
420
431
672
417
422
425
424
426
783
430
784
785
432
427
433
739
435
434
436
437
440
441
438
447
Name
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore & Cartier Islands
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
British West Indies
Brunei
Bulgaria
Burkina Faso
Burma (Myanmar)
Burundi
Cambodia (Kampuchea)
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Revised 11/4/2013
Code
444
445
450
452
453
454
455
456
457
458
459
460
561
462
465
470
476
770
472
473
475
474
479
480
481
485
490
482
484
491
492
486
487
493
494
495
496
517
497
498
503
500
502
Name
Chad
Chile
China, People's Rep of
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Republic of
Cook Islands
Coral Sea Islands
Costa Rica
Cote d’Ivoire (Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of Congo (Zaire)
Denmark
Djibouti
Dominican Republic
Dominica
East Timor
Ecuador
Egypt (A.R.E.)
El Salvador
England
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
French Southern & Antarctic Is
Gabon Republic
Gambia
Georgia (C.I.S.)
Germany
Ghana
APPENDIX B
FOREIGN COUNTRY CODES
Code
504
505
506
507
510
512
671
669
511
513
514
515
520
525
528
530
535
540
545
550
555
560
562
563
565
567
570
572
575
577
579
580
585
578
590
592
595
596
598
600
597
593
599
601
Name
Gibraltar
Greece
Greenland
Grenada
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island & McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Jan Mayen
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, (North)
Korea, Republic of
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Revised 11/4/2013
Code
619
618
602
605
763
609
608
764
603
604
765
610
612
614
611
622
766
613
617
616
623
615
621
620
624
625
630
635
636
637
638
641
640
643
799
645
646
650
651
653
655
660
665
664
Name
Macedonia
Madagascar
Malawi (Central Africa)
Malaysia
Maldives
Mali
Malta
Man, Isle of
Mauritania
Mauritius
Mayotte
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands
New Caledonia
New Zealand
Nicaragua
Nigeria
Niger
Niue
Norfolk Island
Northern Ireland
Norway
Oman
Other Foreign
Pakistan
Palau
Panama
Papua New Guinea
Paracel Islands
Paraguay
Peru
Philippines
Pitcairn Islands
APPENDIX B
FOREIGN COUNTRY CODES
Code
666
667
668
670
677
676
678
680
702
681
754
688
689
685
690
692
697
691
686
693
707
698
696
694
700
695
699
443
682
683
684
687
703
704
708
706
705
710
715
451
717
718
Name
Poland
Portugal
Portuguese E. Africa
Qatar
Romania
Russia
Rwanda
Ryukyu Islands
S. Georgia & S. Sandwich Is.
Saint Kitts & Nevis
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Spratly Islands
Sri Lanka (Ceylon)
St. Helena
St. Lucia
St. Pierre & Miquelon
St. Vincent & the Grenadines
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Revised 11/4/2013
Code
720
722
719
723
724
725
728
730
731
729
716
732
733
734
736
740
743
744
745
750
752
756
758
755
771
675
799
Name
Thailand
Togo
Tokelau
Tonga
Transkei
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam Socialist Republic
Wales
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
(Largest number allowed)
Inactive Codes (Do not Report):
401
Abu-Dhabi
423
782
Bassas Da India (Madagascar)
471
Czechoslovakia
478
East Africa
483
Europa Island (Madagascar)
489
French Guiana (France)
721
Gambia, the
501
Gaza Strip (Israel)
499
Germany (East)
508
Glorioso Islands (Madagascar)
509
Guadeloupe (France)
571
Juan De Nova Island (Madagascar)
606
Malagasy Republic
APPENDIX B
FOREIGN COUNTRY CODES
Code
607
673
726
727
735
738
749
753
757
751
701
760
772
Name
Martinique (France)
Reunion Islands (France)
Tromelin Island (Madagascar)
United Arab Republic
U.S.S.R
Viet Nam, North
West Africa
West Bank (Israel)
Yemen South
Yugoslavia
Revised 11/4/2013