Customised Group Virtual Program Questionnaire

Thank you for your interest in developing a Customised Group Virtual Program with CISaustralia. 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. Does this program have funding?*
If other:*
2. Proposed name of the program?*
3. What is the name of the course(s) being taught as part of this program that students will receive credit for? (If applicable)*
4. Briefly describe the program learning outcomes:*
5. What are the anticipated program dates?*
If you do not have specific program 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.
6. How many contact hours are required for this program?*
Contact hours is the amount of time the student will spend in face-to-face contact during the program. This includes any activity that forms part of the schedule. For example: presentations, workshops, virtual tours, etc.
7. How many project hours are required for this program?*
Project hours are those spent by the student working on assigned project(s). This will help us understand the program outcome better. We can accommodate this time into the program schedule.
8. What country (or multi-countries) will this program be centred around?*
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.
11. Please describe the types of virtual academic visits you would like included in the program? (e.g. industry, NGOs, embassies, universities, guest speakers, museums, galleries, etc.)*
12. Do you have contacts (or access to contacts) in-country for these virtual visits? (If applicable)*
13. In addition to the cultural orientation, what types of virtual cultural activities would you like included? How many? (e.g. city tours, cooking classes, cultural immersion activities, etc.)*
14. Do you need time allocated in the program itinerary for unfacilitated teaching or debrief sessions? If so, how often / how long?*
15. Do you have a sample itinerary? If so, please upload a copy here:
(PDF or Word document, maximum 50MB)
Max. file size: 50 MB.
Previous On-Site Program (if applicable)
Describe the program if it has run in the past as an on-site program.
16. Has this particular program run on-site in the past? If so, please upload an itinerary:
(PDF or Word document, maximum 50MB)
Max. file size: 50 MB.
17. What did you feel were the strengths and/or weaknesses of the program?
Final Comments
18. Any other information, thoughts, comments, stories you would like to add?
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If you have any questions, we are also available by phone:

+61 (0) 7 5571 7887

Customised Group Virtual Program Questionnaire

About the Program

Previous On-Site Program (if applicable)

Final Comments

Adventure Awaits

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