Faculty Application - Step 1 of 5

Please note the following before completing the application:

Hard copy of the application will not be accepted
Do not fill out the form in all upper or lower case. Use proper capitalization
You need your passport information ready
To finish the application process, print a WAIVER form (Step 5) and mail to CCID Office at the address provided in the form. Please make sure this computer is connected to a printer.

Program

Biological, Tropical and Environmental Sciences

China's Economic, Social and Cultural Impact Due to Globalization

Global Business in an Emerging Democracy

Innovation, Experience Economy and Event Management (Denmark)

Life in Modern Guatemala: The Old and New

Transcultural Nursing - June/July

Transcultural Nursing - May

Applicant Information

Provide your name exactly as it appears in your passport or your birth certificate.

First name*

Middle name*

Last name*

Birthdate*

Gender

Race/ethnicity

Addresses

College Address

Street address*

City*

State*

Zip code*

Permanent Address

Street address*

City*

State*

Zip code*

Phone Contact

College phone*

Home phone*

Cell phone

Email address*

College Information

College*

College department*

Current job title*

Passport

Passport Processing Time Warning: if you need a new passport or need to renew an existing one, we urge you to apply as soon as you know you want to travel on this program. Currently, an average wait time for any new passport is about 3-4 months! (which you may not have if you submit right on the application deadline). DO NOT DELAY receiving your passport as CCID will not refund any preliminary fees to you should you miss the beginning of your program abroad due to late receipt of your passport.

Are you a US citizen?

If not a US citizen, what is your country of citizenship?

Do you have a valid US (or other country, if not a US citizen) passport?*

If yes, what is your passport number?

Passport expiration date

If you are a new faculty in the Troika program, CCID will need a COPY OF YOUR PASSPORT photo page at least 21 days (3 wks) before your program departure date. Scanned or mailed copies are accepted. Set copier to photo copying so the picture is visible. Please DO NOT FAX.

Dietary and Medical Information

Dietary restrictions (Not all dietary restrictions may be accommodated depending on the limitations of the local food supply. Please discuss your and your students' special dietary or medical needs with the in-country partner.)

Special medical conditions. (Required for emergency situations only. This information is kept confidential).

* required field