International Consortium for Educational and Economic Development

Application For Membership

Membership is open only to institutions from Canada, Mexico, and United States.

* Indicates required fields

* Name of Institution:
* Street Address:
* City:
State:
* Country:
Zip/Postal:	(Must be numeric)

President/C.E.O./Rector:
* Telephone:	(ddd-ddd-dddd)
Fax:	(ddd-ddd-dddd)
* Email:	(Must conform to the correct email format)
Web Page:

Additional Person to Contact:
Telephone:	(ddd-ddd-dddd)
Fax:	(ddd-ddd-dddd)
Email:	(Must conform to the correct email format)
Web Page:
Institutional Data:
Student Enrollment:(Headcount)
International Student Enrollment:
Full Time Faculty:
Part Time Faculty:
Degrees Offered:

* Signature (College President /Rector / C.E.O.)	* Date (Date format: dd/dd/dddd)
*Note: ICEED will forward an invoice for US $800 dues after approval of this application.

International Education Activities:

Is a coordinatior for international programs designated?

Yes No

Please indicate the types of international activities at your institution within the past year.

Enrollment of international students
Students study abroad
Internationalization of curriculum
Faculty exchange / Internships
English as a second language
International visitors
International projects
Other (specify)

ICEED Activities and Services:

Please rank the following ICEED ativities and services in priority of interest to your institution. (1=Highest, 5=Lowest)

Enrolling international students
Student study abroad programs
Consulting services
Faculty / Staff international
Hosting international faculty interns
Hosting international visitors
International education seminars / conferences
Short term faculty / staff assignments abroad
Development projects
International education info networking
Other (specify)

Special Programs:

Please list vocational or technical programs with unique characteristics, or in which your institution has special expertise.

Comments: