University of California at Berkeley
University of California, Berkeley Visiting Scholar and Postdoc Affairs (VSPA) Program
VSPA Application for Visiting Scholar Appointments
Check one:
Initial appointment
Extension of Appointment
See visiting scholar definition at and postdoc definition at to determine which application to use. Type application online and send as an e-mail attachment to the sponsoring campus unit.
If not possible, type and send by fax. DO NOT WRITE BY HAND.
Personal Data
|Name | |
Family First Middle Initial
|Date of Birth | | | |Sex: Male Female |
| |Month |Day |Year | | |
Permanent Address
| | | |
|Street |City |State/Country |Zip Code |
|Country of Citizenship | |(Anticipated) Visa Type | |
|E-mail Address |
|Purpose of Research Visit | |
Proposed Visit
|Beginning Date | |Ending Date | | |
Highest Degree
|Degree | |Date |Institution/Location | |
|Are you currently in a degree program elsewhere? No Yes | |
| If yes, what kind of program? Doctoral Masters |
| If yes, at what institution? | |
Employment
|Have you been a professor, associate professor, or assistant professor elsewhere? No Yes |
| If yes, where? | |
|Are you currently a UC employee? No Yes If yes, where? | |
|Signature of Applicant | |Date | |
For School/College/Department/ORU Use Only
|Sponsoring Campus Unit | |
|Administrative Contact |Annette Barnes |E-mail |annetteb@berkeley.edu |Phone |2-4064 |
|Visitor’s Work Location / Lab |470 Stephens Hall |Faculty Sponsor |
|Source of Funding while at UC Berkeley |
|Amount per month $ |Personal |Source (funding agency) | |
|Will a payroll title code be assigned to the visitor? | No Yes |If yes, what title code? | |
|Signature of Dean, Chair or Director | |Date | |
For VSPA Program Use Only
Title Approved / Recorded
Visiting Scholar Visiting Student Researcher
|By: | |Date: | |
2/2006
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