Oklahoma City University : Visiting Scholar Application

Application for Position as Visiting Scholar

PERSONAL INFORMATION
Date
First Name
Last Name
Address

City	State
Zip/Postal
Home Phone
Work Phone
Email
Current Institution

Proposed dates of residence:		Would you consider alternative dates?
From:		From:	Alternative Date #1
To:		To:
		From:	Alternative Date #2
		To:

Discipline:
Proposed Course(s)
Please provide a brief description of your interest related to teaching and other interaction with our students and faculty:

Please describe your interests related to scholarly pursuits while in residence at OCU:

Scholars are expected to provide some outreach to the Oklahoma City community. Please describe how you might fulfill this expectation (public lecture, reading, outreach to area schools, outreach to community organizations, outreach to area religious groups, other):

Others who will be in residence while at Oklahoma City:
Name:		Relation to Scholar:
Name:		Relation to Scholar:
Name:		Relation to Scholar:
Professional References:
Name:		Name:
Relation:		Relation:
Phone:		Phone:
Name:
Relation:
Phone:
Please attach the following two documents: Letter of support from your current department chair or dean:

Current CV: