CROSS CULTURAL ENCOUNTERS
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1 CROSS CULTURAL ENCOUNTERS 5 MCGILL COURT, NORTH ROCKHAMPTON QLD., AUSTRALIA 4701 PHONE: SKYPE: cce.kym.treacy or cce.tammy.harth Kym@ccencounters.com and Tammy@ccencounters.com IMPORTANT: PLEASE PRINT OUT A COPY FOR YOUR RECORDS Name of University/College/Group CUSTOMISED PROGRAMS SURVEY FORM Preferred Custom Program Name: Today s Date: TRAVEL DETAILS Year of Travel: Estimated Month: Estimated # of Days: If you know specific program dates please provide: Departure date Return date From USA: to USA: CONTACT INFORMATION Name of Study Abroad/Short Course Co-ordinator at your campus: Mailing Address Street /PO Box Phone: Fax: City & State Zip Code: Name of Faculty Leader for the Program at your Campus: Position/Title: Phone: Is this Faculty travelling with the Program? Yes No
2 Who will be the PRIMARY contact Person? Faculty Leader Study Abroad Advisor Other If Other, please provide name & Would you like us to include in future correspondence: Faculty Leader Study Abroad Advisor Other Please list others to be included: Name: Title: Developing the program proposal, budget and itinerary can often take 3-4 weeks to prepare. If you have a specific deadline please indicate it here: INTERNATIONAL FLIGHT OPTIONS Cross Cultural Encounters strongly recommend your group travels together on a group flight. Do you want students to travel together to and from the USA on a group flight? Yes No Cross Cultural Encounters can easily assist you in sourcing a quote for all your flights from STA Travel. STA Travel quotes are highly competitive with all other providers and if they arrange the group flights, they will also help students arrange their add-on domestic airfares to and from their home Cities. Would you like Cross Cultural Encounters to put you in touch with STA Travel to help arrange your travel details? Yes No Travel & Health insurance is essential! Cross Cultural Encounters will require confirmation from all students that they have Travel and Health Insurance before departing the USA. STA Travel can arrange travel insurance on your behalf if required. PROGRAM REQUIREMENTS LOCATIONS Please indicate which Country / Countries you would like to visit: Australia New Zealand Fiji Please list preferred Cities / Towns and the duration you wish to spend in each location:
3 ACADEMIC DETAILS Note: Faculty Leaders on faculty-led short courses often teach the majority of the subject to their students while abroad, however, these questions will help us decipher and understand more about the academic content and how we can supplement the program with guest lecturers and visits. Average level of all participants (e.g. year in School, Academic major): What is the name, number and subject description of this course at your University? Please send syllabus or outline if available): At what level will this course be offered? (e.g. Freshman, Sophomore, Junior, Senior, Graduate): PROGRAM REQUIREMENTS: LECTURES # of Guest Lecture hours needed: # of Field hours required: What is the expected duration of each Guest lecture? Are there pre-requisites / prior coursework / a minimum GPA required for this course? Yes No If yes please describe: Do you require Guest speakers to be Faculty from a local University? Yes No (NOTE: all guest lecturers will be professionals from the local community unless otherwise specified) Please describe what types of guest speakers you would like and specify topics to be covered: Do you already have established guest lecturers or other contacts that you would like us to use in creating your itinerary? Yes No If yes, please list names & contact details and specify topics to be covered:
4 Approximately how many lectures do you expect your Faculty to teach on this program? What is the expected duration of each lecture? Will the Faculty require meeting rooms for lectures or meetings? Yes No What equipment will you require? (e.g. laptop, projector, screen, whiteboard, butcher s paper) PROGRAM REQUIREMENTS ACTIVITIES Do you have any specific activities you want to do? Yes No If Yes, please list: Approximately how many unscheduled days per week would you like to schedule for your students? Which days of the week would you like to be unscheduled (e.g. Sat, Sun?) ACCOMMODATION DETAILS Most accommodation in Australia, New Zealand and Fiji is done on a budget with clean, safe facilities but not the usual hotel flair of many US Hotel chains. In addition, we often use hostel (backpackers) style accommodation with private rooms, as they are centrally located and easy to use with group travel. What style of accommodation do you prefer for your students: Dorm style / Hostel 4 6 people per room (least expensive) Share rooms in hotels 2 3 people per room Single / private rooms in hotels (Approx $150-$200 per person per night) Bathrooms are often shared. Do you require en-suite facilities for the students? Yes No Faculty Leaders are booked into the same accommodation as students but in single rooms with en-suite facilities. Comments or specific requests about accommodation for your program: (close to City/Restaurants etc.
5 SPECIAL NEEDS Alcohol with meals is culturally acceptable for students of age (18 years) in Australia and New Zealand. Please outline any restrictions, alcohol or otherwise we should be aware of. It is a requirement of Cross Cultural Encounters that you provide us with a copy of your Code of Conduct upon acceptance of the program. PRE-ARRANGED MEALS Cross Cultural Encounters can arrange meals during your program. We often only budget for breakfast each day and let the students find their own lunch and dinner options. This helps keep tour costs affordable since group lunches tend to be more expensive than individual purchases. We recommend including program dinners at the start and end and leaving the group flexible for the other days. You can design whatever meal plan you would like for your group by filling out the chart below. Drinks are not included with meals. Please specify how many meals you would like us to pre-arrange and budget for: Continental breakfast # Hot breakfast # Lunches # Dinners # or daily or daily or daily or daily LEADER INFORMATION IN-COUNTRY CROSS CULTURAL ENCOUNTERS REPRESENTATIVES OCEANIA Cross Cultural Encounters does not send a staff representative along with the programs in Oceanic countries. Our Program Managers closely monitor the Program 24/7. They ensure that all pickups, activities and details are reconfirmed each day of the tour. We can provide a full-time representative for an additional cost to travel with your group if you feel strongly that it is a requirement. FREE OF CHARGE FACULTY LEADERS Generally the budget includes one (1) Faculty leader travelling with the group as free of charge for all arrangements as detailed in the itinerary (e.g. activities, accommodation, included meals). All other expenses (e.g. non-included meals, international airfare, US domestic airfare, personal incidentals) are the responsibility of the Faculty or the Home University UNLESS clearly specified.
6 Please provide details of all Faculty travelling with the Program: Name: Name: Name: Title: Title: Title: Should all costs associated with the Leader(s) be incorporated in the budget? Yes No If No, what costs should be left out of the budget? Will the spouse/partner of any of the Leader(s) be travelling as well? Yes No If Yes, please provide details: Spouse costs are not usually included in the budget, however, we do provide costs for separate payment. Do you want any spouse costs incorporated in the budget? Yes No If Yes, which costs? FINANCIAL CONSIDERATIONS In all cases Cross Cultural Encounters provides the best price quote based on your answers above (e.g. duration of program, accommodation style, included meals and destinations). The following questions will not alter that quote but will however provide us with a better understanding of your expectations and how we might best achieve them. What do you think is your expected maximum Program cost per participant (US dollars) excluding international airfare & and any University fees. What program components listed in this document would you be prepared to sacrifice to keep costs down? ANTICIPATED FREQUENCY OF THIS PROGRAM How often do you anticipate running this course? One time only Annually Biannually Unknown Other frequency if none of the above: Will the Faculty Leaders change every time? Yes No
7 CROSS CULTURAL ENCOUNTERS ADMINISTRATIVE ROLE Our goal is to design and deliver a program that meets your overall plan for a short course abroad as well as all your academic goals. Cross Cultural Encounters works directly with Universities, not students, when we offer a Custom Designed program, therefore our role is as a provider of your program. We will be in contact and always available from the time you submit this Survey form until the time you return back home after your program. We do not speak with your students directly, but rather offer you support as you prepare and manage your group for travel. AS PART OF THE FACULTY-LED SHORT COURSE PROGRAM PROCESS WE WILL PROVIDE THE FOLLOWING TO YOU: 1. Pre-Departure planning An itinerary and program fee to which you can add your own specific fees or components. Discussions and liaison with your faculty and your staff to ensure the program is built to your specifications. 2.Program Departure & Orientation We will send you mandatory forms for our students to complete (contact / emergency details & medical declarations) We will provide relevant departure information for your students and faculty. We will invoice your University for the program. 3.On Arrival at the Program Site On arrival in country you will be met and greeted by Cross Cultural Encounters staff. Your group will receive an orientation & settling in presentation. Cross Cultural Encounters will oversee the daily program managements ensuring that all details are fixed and the program runs as outlined. We will make all payments to suppliers, hotels, transfers etc. as included in your program you do not have to manage these payments while you are trying to manage your group. We provide 24-hour care / emergency phone service while your group is in country. YOUR UNIVERSITY S ADMININISTRATIVE ROLE The following activities are usually the responsibility of your University: Advertising and marketing on the campus to encourage student participation Collecting applications for this program from your students Conducting the acceptance process for this program Sending acceptance letters / materials Providing pre-trip orientation at your campus with your group Arranging health/emergency insurance for your group Training and working with accompanying faculty Collecting program fees from participants
8 Upon submission of this document back to Cross Cultural Encounters the following steps will happen: One of our overseas based representatives will contact you soon to discuss the initial details of the program. We will prepare a detailed proposal, budget and itinerary document and return to you via with 3-4 weeks. Note that time lines may vary based on seasonal workloads. From there you will have ample opportunity to review, update and make changes until we come to a final version that you are happy with. Once completed we will have you sign our Proposal Acceptance form and we will begin to make bookings and all program arrangements. We will schedule a pre-departure conference call with the group leader before your group departs for overseas Please return this form to: Kym Treacy and Tammy Harth Directors Cross Cultural Encounters 5 McGill Court North Rockhampton Queensland, Australia this form to: Kym@ccencounters.com and Tammy@ccencounters.com Please keep a copy of this printout for your records
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