Request To Invite Visiting Scholar

* = required field

Some content may be updated based on selection

Request To Invite Visiting Scholar

This form is to be used for all levels of the approval process including information required for background check and visa status of Scholars. Additionally, please fill out all fields and review the approval procedures before submitting this form. If the question is not applicable, please enter "n/a" in the form field.

Section I. Host Faculty Member Information

To be completed by the University host faculty member prior to the beginning of the visiting scholar’s program activities.

I have completed General Office/Department Volunteers Form

CV/Resume

Official Transcripts required for teaching

Name of Host Faculty Member

Date

Stetson University ID Number

Department

Telephone Number

Email Address

Number of visiting scholars scheduled for this program/activity

Proposed length of stay for the visiting scholar identified below

Number of visiting scholars previously sponsored by faculty member

Section II. Visiting Scholar Information

Name of Visiting Scholar

Date of Birth

Gender

Preferred Pronouns (e.g. She, Her, Hers)

Driver’s License/ID Number

Contact Address

Address 1

Address 2

City

State

ZIP/Postal Code

Country

Other Information

Email Address

Telephone

Country of Birth

Country of Citizenship

Country of Legal Permanent Residence

Title of Employee

Current Employer

Employer Telephone

Employer Address

Amount of Funding

Employer Website

Source of funding to cover scholar’s living expenses?

Will Stetson University be required to sign any agreements to authorize the visiting scholar's placement and/or participation in research/other activity at Stetson University?

If an agreement is required by the home institution to authorize the visit, the SU host faculty member should request a copy of the agreement from the home institution for endorsement by the Office of the Provost and Academic Affairs.

Section III. Visiting Scholar Visa Status

Check one of the following to indicate whether the visiting scholar requires a visa or not. For more information about visa types and related activity, visit the Department of State at: state.gov

This visiting scholar is a U.S. citizen or Permanent Resident, Asylee, or Refugee and does not need a visa.

This visiting scholar will enter on a visitor (business/tourist) visa or visa waiver.

[fix this]The visiting scholar will need a J-1 Short Term Scholar visa for stays of 3 weeks to 6 months, applicable to professors and researchers visiting U.S. institutions to lecture, observe, or demonstrate skills.

Note: International visitors classified as Visiting Courtesy Postdoctoral Associate, Visiting Courtesy Graduate Research Assistant, and Visiting Courtesy Undergraduate Assistant must obtain J-1 visas regardless of the length of time of the visit in order to comply with U.S. Immigration regulations unless already on OPT or Academic Training.

This visiting scholar will be visiting for a period between 6 months and 2 years and will require a J-1 Professor and Research Scholar visa. Please note that any scholars (and their dependents) who use this visa are subject to the 12 or 24 month bars.

This visiting scholar (international) is currently in the U.S. on Optional Practical Training (OPT), Academic Training, or as a dependent to either a student on a J-1 or F-1 student visa, or another legal category which allows this activity.

Other

For additional assistance, contact world@stetson.edu or 386-822-8165.

Section IV. Purpose of the Visit

What is the purpose of the visit?

What are the clear goals, activities, and anticipated outcomes?

Will the proposed research involve human subjects, animal subjects, or use of hazardous materials or chemicals?

What are the benefits of this visit to you and your department/unit?

How does this visit advance Stetson's mission and the value of a Stetson education?

How will you provide oversight of the visiting scholar?

How much time per week will you spend with the visiting scholar?

Will others work with this visiting scholar? Check all that apply?

Faculty

Staff

Graduate students

Undergraduate students

Will you be on leave during some or all of the visiting scholar's stay at Stetson University?

What other factors should the University know in order to fully vet this visiting scholar?

Section V. Special Considerations

Facilities Usage: Please indicate to which resources and facilities (name of buildings, laboratories, room numbers, etc.) the visiting scholar will require access

Intellectual Property: Work at the University that results in intellectual property considerations should be directed to the executive director of academic administration at the Office of the Provost and Academic Affairs.

Section VI. Stetson Funding To Support Faculty-Scholar Activity

Please indicate funding resources you will use in support of the faculty-scholar activity.

Source of funding, including external grants/sponsored projects (Fund, Org, Program, Account Codes)

Source of Funding

Amount of Funding

Source 1

Amount 1

Source 2

Amount 2

Source 3

Amount 3

Section VII. Approvals

I have reviewed the above and certify that the host faculty member (or named alternate) has the available time to provide oversight and supervision of this visiting scholar and that the visit provides a benefit to Stetson University through ongoing and future collaborations, research and information-sharing between the host faculty member (and department/unit) and the visiting scholar. Access to all of the indicated Stetson University facilities is also approved.

I acknowledge that any unrestricted gift from the visiting scholar's home organization may not be made directly to the host faculty member. Funds shall be deposited into a Foundation account as directed by University policy and may be used to defray the visitor's expenses as delineated by agreement between the visiting scholar’s home institution and Stetson University.

Signature

Date

Please wait for files to finish uploading