EmailMe Form - Visitor Request Form

Name *

First Last

Institution/Organisation name: *

Country *

City *

Describe your institution/organisation's mission and identify academic strengths, programs and disciplines: *

Primary contact name for organising details of the visit: *

Primary contact phone number: *

### - ### - ####

Primary contact email address: *

Will the primary contact person be participating in the visit? *

Yes

No

Proposed start and end date(s) and time(s) for the visit: *

Provide information for each member of the delegation.
Include: first name and last name, title, department, email address, and a website link to a professional bio (if available). *

What are the intended goals for visiting Charles Darwin University? *

What collaborations or relationships already exist between your institution/organisation and Charles Darwin University? *

Have you previously visited Charles Darwin University? If so, please describe your visit(s) and the outcomes: *

Please list any specific colleges, offices and/or professional/academic staff you wish to meet with and the objectives for each of these meetings:

Would you like a brief tour of campus during your visit? *

Yes

No

Is any member of the group an alumnus of Charles Darwin University? *

Yes

No

If yes, please provide details:

Will you need an invitation letter for visa purposes? *

Yes

No

Note:

To maximise the benefit of the visit, international delegations should either have a working knowledge of English or be accompanied by an interpreter.

Charles Darwin University does not provide this service.