Office of International Programs Impact Report

Please submit this report within 30 days of completion of travel if funding was received from the Office of International Programs.

Description of Award please briefly describe the purpose for this award (i.e. travel dates and location and primary reason for the international travel).

Your name

Your Unit: If Graduate Student, please provide the name of your advisor.

Your E-Mail Address

Your Phone Number

University Status

Faculty Staff Extension Undergraduate Student Graduate Student

First time international traveler?

Yes No

Amount of Award Received: ($)

Date Received: (Month/Year)

Estimated Amount of Funding Leveraged ($):

Please provide a brief paragraph describing the overall results of your travel and the impact on you personally and professionally. Please also include a summary of how this experience contributed to broader departmental or College international goals.