Visiting Scholar/Honorary Fellow Request Form Visiting Scholar/Honorary Fellow Request Form Thank you for your interest as a visiting scholar or honorary fellow in the Department of Asian Languages and Cultures at the University of Wisconsin - Madison. To better assist us, please provide the following information. Family Name* Given Name* Date of Birth* MM slash DD slash YYYY Proposed Start Date* MM slash DD slash YYYY Proposed End Date* MM slash DD slash YYYY Email Address* Address Line 1* Address Line 2 Address Line 3 City/Province* Country* Postal Code Professor you are requesting to work with* Highest Degree Earned*Bachelor'sMaster'sPhDPostdoctoralBriefly describe your research proposal (2-3 sentences)*If invited as a visiting scholar/honorary fellow, would you be willing to take part in a language exchange with current undegraduate students?* Yes No Curriculum Vitae*Max. file size: 24 MB.Research Proposal*Max. file size: 24 MB.