Ref No.___________________
(To be completed by the AUA Secretariat)
AUA Scholars Award (2020-2021)
Academic Visit Summary & Review
Directions
This document should be completed by the AUA Scholar and the host professor.
Please type in answers to all the blanks.
The document shall be submitted to the AUA Secretariat ([email protected]) in the form of PDF within 30 days since the end of the academic visit.
Please use the following format for your email subject: AUASAP2020 Summary+abbreviation of host institution name+last name of AUA Scholars+starting date of visit, e.g., AUASAP2020 Summary UAEU Mahmood 15-11-2020.
Part I. AUA Scholar Given Name
Surname (if any) Gender
Date of Birth DD/MM/YYYY
Title/Designation (e.g. Professor/Associate Professor/Assistant
Professor/Doctor/Research Fellow/Dean…)
Department/School/Faculty/Researc h Institute
Home University
Telephone (country code) + area code + number Email
Address & Postcode (for receiving the AUA Scholar Certificate)
Part II. Summary of Academic Visit (to be filled by AUA Scholar) Starting Date
(Date of arriving at the host institution)
DD/MM/YYYY
1
/4
Ending Date
(Date of departing from the host institution)
DD/MM/YYYY
Number of Working Days
(Refer to the Application Guidelines to calculate the number of working days)
Primary Purpose(s) of Visit ☐ Offering Courses / Lecturing
☐ Research / Field Study
☐ Attending Courses
☐ Attending Conferences / Seminars
☐ Others (please specify):
Schedule of Academic Visit
(Please enter the actual activities on the working days of the visit)
DD/MM/YYYY or DD/MM/YYYY-
DD/MM/YYYY
Activities
Summary of Academic Visit (Please enter a brief summary of the academic visit. What did you do? Which parts of the visit were most valuable to you? Are there any highlights in the visit? To what extent has the visit achieved your anticipated outcomes?
Any other comments or suggestions?)
(min. 300 words)
2
/4
Signature of AUA Scholar (electronic signature applicable)
Date (DD/MM/YYYY)
Part III. Photos (attached separately)
Please provide three high-definition photos of the AUA Scholar: one is a half-length portrait photo of the AUA Scholar, and the other two are photos taken during the above-mentioned academic visit (preferably one photo with the host professor). You are welcome to provide more photos. The size of each photo shall be 2MB or even larger.
Please kindly note that AUA may use the photos or share them with third parties for publicity purposes of AUA.
Photo File Name Photo Description
A e.g. Portrait Photo of Dr. Seah
B e.g. It was taken in Prof. Ahmed’s lab. His research team was presenting to me the newly synthesized compound.
C
Part IV. Review by Host Professor (to be filled by host professor) Name of Host Professor
Title/Designation (e.g. Professor/Associate Professor/Assistant
Professor/Doctor/Research Fellow/Dean…)
Department/School/Faculty/Researc h Institute
Host Institution
Telephone (country code) + area code + number Email
Review and Comment
(Please enter a brief evaluation on the performance of the AUA Scholar. You may also share with us the highlights of the visit and your
comments/suggestions on this program.)
(min. 200 words)
3
/4
Signature of Host Professor (electronic signature applicable)
Date (DD/MM/YYYY)
