Custom Internship Abroad Program Questionnaire

Thank you for your interest in developing a customized program with us! Please answer the questions below to the best of your ability. This will allow us to get back to you with some ideas on how we might work together.

About You
Name*
First Last
Salutation*
Institution*
Department
Other Institution Name
Email*
Enter Email Confirm Email
Phone*
Your Role in Relation to the Program*
About Your Progam
Your Program Model*
Course Title or Program Topic
Program Destination(s)
For multi-country programs, please select all destinations you hope to visit. Don't see your country listed here? Let us know where you'd like to go in the 'other' field below.
Other Destination
If your desired program destination is not listed above, let us know where you want to go here.
Approximate Start Date*
This is tentative and can be adjusted.
Month
Day
Year
Approximate End Date*
This is tentative and can be adjusted.
Month
Day
Year
Hidden
Estimated Number of Weeks
Next Steps
When do you need a proposal?
Month
Day
Year
How did you hear about CIS Abroad?
Please select all that apply
Please tell us more about your program goals:
Teach Your Course Abroad
Tailor an Existing CIS Abroad Program
Create a Hybrid Program
Create a Custom Program
Program Type to Tailor*
Experiential Learning Program to Tailor*
Study Program to Tailor*
Desired Learning Outcomes*
Requested Activities*
Do you have any specific visits in mind? If applicable, please indicate where you have existing contacts.
Target Majors/Degrees for this program*
Will this program fulfill students' degree requirements?*
Housing & Facilities Information
Preferred Student Housing Type*
Student Housing Occupancy*
Leader Housing*
Learning Environment*
Additional Details
Has this program run before?*
Estimated Group Size*
Sample Itinerary
Please share if you've made one.
Max. file size: 50 MB.
Program/Course Syllabus
Please share if you have one.
Max. file size: 50 MB.

Custom Internship Questionnaire

About You

About Your Progam

Next Steps

Teach Your Course Abroad

Tailor an Existing CIS Abroad Program

Create a Hybrid Program

Create a Custom Program

Housing & Facilities Information

Additional Details