Description of the Program (400-600 words). Please include the nature of the institutional program or project to be featured (if you have a brochure on the program or project, please enclose five copies), a proposed format, and presenters for the event.
Preliminary schedule of events for the exchange visit.
Projected budget
CV of Coordinator
These documents may be mailed with a printed version of the cover form to: Lilly Fellows Program
Linwood House -1401 Linwood Avenue
Valparaiso University
Valparaiso, IN 46383
OR you may submit the cover form on-line (below) and email the rest of the documents as attachements to: lillyfellows.program@valpo.edu. Be sure to include the name of your institution in the subject line.
Network Exchange Program Application
Names entered below will be considered signatures for the application.
Signature of the Coordinator:
Name
Title
Signature of Host Institution Official:
Name
Title
You will receive a copy of this information via email.
Lilly Fellows Program Linwood House - 1401 Linwood Avenue
Valparaiso University
Valparaiso, IN 46383
Tele 219-464-5317
Fax 219-464-5496
Network Exchange Programs
Lilly Fellows Program
