UM International Visitor Screening Form

UM International Visitor Screening Form

Visitor Information

Visitor's Full Name*

Visitor's Organization*

Source of Funding for the Visit*

How will the Visitor be funded during their time at the UM? (e.g., UM stipend, employer funded, scholarship, personal funds, etc.).

If employer or scholarship funded, provide the name of the company or scholarship.

If UM funded, provide the source of the UM funds.

Visitor's Country of Origin

Visitor's Country of Citizenship

Visitor's Country of Current Residence

Will the Visitor need an entry Visa to be processed by UM Global Engagement?

Yes

File Upload

Upload any documents relevant to the Visitor/Visit (e.g. CV, resume, invitation letters, etc.).

Please note that a CV or resume is required.

Drag and drop files here or

UM Host Information

Requesting Department

UM Collaborator or Point of Contact (name)

UM Collaborator or Point of Contact (email)

Visit Information

Anticipated Arrival

Expected Duration

Visitor's Title

What will be the Visitor's position title while at the UM (if any)

How was the connection made?

Describe how you met or were introduced to the Visitor and any past or current collaborations with the visitor.

Will the Visitor be involved in scholarly or research activities?

Yes

Research/Scholarly Project Information

Project Title

Project Details

Describe the research to be carried out by the Visitor, including its purpose, objectives, and expected deliverables.

Expected Research Activities

Describe the research activities that will be performed by the Visitor.

Facilities at the UM

Identify ALL UM research labs or university facilities that the Visitor will visit or need to access to conduct the activities.

Current Research Programs?

Will the Visitor be working on research programs?

Yes

Externally Sponsored?

Is the UM host PI’s research program externally funded?

Yes

Attestation

I certify that the provided responses are accurate and compete, to the best of my knowledge. I understand that further information might be requested.

Signature of Host

Typing full name will serve as a signature

Send me a copy of my responses

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