Customised Group Program Questionnaire

Thank you for your interest in developing a Customised Group Program with CISaustralia. This questionnaire is for on-site programs. If you are interested in a customised virtual program, please fill out the Virtual Program Questionnaire.

Please take a moment to complete the following questionnaire and we will be in contact to acknowledge and progress your submission.

Name*
University*
If other University:*
Department / Faculty*
Title*
Email*
Phone*
How did you hear about CISaustralia?*
Please indicate if you are faculty or International Office staff:*
If other:*
Have you spoken to your University's International Office regarding this program?*
What is the name of the Academic leading the program?*
About the Program
Please provide as much detail as possible about the proposed program.
1. Please select the type of program you wish to customise:*
2. Does this program have funding?*
If other:*
3. Proposed name of the program?*
4. What is the name of the course(s) being taught as part of this program that students will receive credit for? (If applicable)*
5. Briefly describe the program learning outcomes:*
6. What are the anticipated program dates?*
If you do not have specific travel dates yet, please tell us what month (and year) you are envisioning, and about how many days / weeks would you like the program to run.
7. What country (or multi-countries) and cities will this program travel to?*
8. How many faculty will be accompanying the group? (If any)*
9. Have you gauged student interest for this program?*
10. How many students do you estimate will participate?*
Program enrolments can range from 10-50+. Average program enrolments are 19.
About the Logistics
Please provide as much detail as possible about the proposed program logistics.
11. What accommodation standard would you like for the program (3 star, 4 star, other)?*
12. Please describe the types of academic visits you would like included in the program? (Industry visits, NGOs, Universities, Museums, Galleries, etc.)*
13. Do you have contacts (or access to contacts) in-country for these academic visits? (If applicable)*
14. What types of cultural excursions would you like included? How many? (City tours, walking tours, cooking classes, day trips, cultural activities, etc.)*
15. Do you need time allocated in the program itinerary for teaching / debrief sessions? If so, how many / how long?*
16. Do you require classroom space? If so, how many days / hours?*
17. How many additional meals might be included, other than breakfast each day and the Welcome / Farewell dinners?*
18. Do you have a sample itinerary (past or current) you are able to share? If so, please upload a copy here:
(PDF or Word document, maximum 50MB)
Max. file size: 50 MB.
Previous Program (if applicable)
Describe the last time this program ran.
19. Has this particular program run in the past? If so, how were the logistics managed?
20. What did you feel were the strengths and/or weaknesses of the program?
Final Comments
21. Any other information, thoughts, comments, stories you would like to add?
CAPTCHA

If you have any questions, we are also available by phone:

+61 (0) 7 5571 7887

Customised Group Program Questionnaire

About the Program

About the Logistics

Previous Program (if applicable)

Final Comments

Adventure Awaits

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