Request for Additional Action to Existing MOU or IA
If continuing the agreement: Have you
attached a copy of the revised MOU or IA to this checklist? Yes No
If continuing the agreement: Have
potential export control issues been mitigated or eliminated through discussion
with the Office of Research Compliance? Yes No
Date:
_____________________________________
Texas State Institutional Representative
Name
|
|
Title
|
|
Department
|
|
Email
|
|
Phone
|
|
Campus mail
|
|
Existing MOU or IA
Title/Entity
|
|
Action Requested (check and complete
one or more sections as needed)
1. Extend the duration
of existing MOU or IA Evidence of success with existing
agreement: Plans for the future: Attach copy of document with track-changes and/or written
edits |
2. Add substantive
addendum to existing MOU or IA Evidence of success with existing
agreement: Plans for the future: Attach copy of document with track-changes and/or new
addendum |
3. Make minor edits to
existing MOU or IA Rationale for edits: Attach copy of document with track-changes or written
edits |
4. Terminate existing MOU or IA Rationale for termination: Perspective of international partner:
Date of termination: Attach copy of communication with partner, if available |
Routing and Required Signatures
Signature
and Approval (Department Chair/Director)
Date |
Signature
and Approval (Academic Dean) Date |
Signature
and Approval (Director, International Office) Date |
Signature
and Approval (Director, Study Abroad, if applicable) Date |
Signature
and Approval (TSUS General Counsel)
Date |
Signature
and Approval (Graduate College Dean, if applicable) Date |
Signature
and Approval (Assistant VP for Research)
Date |
Signature
and Approval (Associate VP for Academic Affairs) Date |
Signature
and Approval (Provost and VP for Academic Affairs) Date |
Remember to:
ü Complete all
relevant sections ü Attach required
documents ü Obtain signatures
in the routing order and forward to the next office ü Retain a copy for
your records ü Contact the
International Office for any questions (512-245-7966) or email
internationalagreements@txstate.edu Note:
The use of courier services such as FedEx, DHL or other similar services is
strongly recommended when sending IAs to international institutions. The
Texas State college, department or office initiating the IA is responsible
for costs associated with the use of courier services for this service. |