Signoff Sheet

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					                     SIGN-OFF SHEET FOR PROPOSED INTERNATIONAL AGREEMENTS

                    International Programs and Services Southern Illinois University Carbondale
          (Review and signatures through and including Legal Counsel to be obtained by Originator of Agreement)

     1.          Name of other institution:
     2.          Country of other institution:
     3.          Name(s) of SIUC originator(s):         ,         ,
     4.          Name of SIUC unit(s) originating agreement:                   ,           ,
     5.          Approvals (Signature of persons in named positions)


     _______________________________________________________________                                 _______________________
     SIUC Originator of Agreement                                                                    Date


     _______________________________________________________________                                 _______________________
     SIUC Originator of Agreement                                                                    Date


     _______________________________________________________________                                 _______________________
     SIUC Originator of Agreement                                                                    Date


     _______________________________________________________________                                 _______________________
     Chairperson/Director of Originating Unit                                                        Date


     _______________________________________________________________                                 _______________________
     Chairperson/Director of Originating Unit                                                        Date


     _______________________________________________________________                                 _______________________
     Chairperson/Director of Originating Unit                                                        Date


     _______________________________________________________________                                 _______________________
     Dean of College                                                                                 Date


     _______________________________________________________________                                 _______________________
     Dean of Graduate School                                                                         Date


     _______________________________________________________________                                 _______________________
     MOU approved as to Legal Form / SIUC Legal Counsel                                              Date


     _______________________________________________________________                                 _______________________
     Director, International Programs and Services                                                   Date


     _______________________________________________________________                                 _______________________
     Vice Chancellor Student Affairs                                                                 Date


     _______________________________________________________________                                 _______________________
     Provost and Vice Chancellor                                                                     Date

This form with the appropriate signatures and a copy of the complete proposal should be returned to International Programs and
Services where the formal documents (on special paper and in a special folder) will be prepared for the signatures of the Chancellor
and appropriate CEO of the other institution.

                                                                                                                              08/13/2007

				
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