Visit Request Form

Name of International Organisation/Institution
Contact Name Contact Name First Last
Position
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Website
Email
Attendee/s Name - Attendee/s Title
Date of proposed visit Date of proposed visit / DD / MM YYYY
Host time

Host time 9.30 am – 11.30 am 2.30 pm – 4.30 pm
Mode of transport to UOW campus
Contact Number
What is the main purpose of the proposed visit?
Any documents providing supporting information about the purpose of the proposed visit may also be attached

Attach Files
Is there an existing relationship with UOW?

Is there an existing relationship with UOW? Yes No
Is there a formal agreement in place?

Is there a formal agreement in place? Yes No
Are there any informal links (eg collaborative Research)?
Please provide summary details’ of the information relationship:
Is there an existing relationship with other Australian institutions?

Is there an existing relationship with other Australian institutions? Yes No
If yes, please provide details
Please provide a brief biography of each delegate attending the visit.
Maximum of 9999 characters allowed. Currently Entered: 0 characters.