Form No.3 – International Partnership Proposal Form: Non-Academic Institution

INTERNATIONAL PARTNERSHIP PROPOSAL FORM: NON-ACADEMIC INSTITUTION

A. Profile of Potential International Partner

Logo of Potential Partner *

No file chosen

Name of the Potential International Partner *

Street Address *

City

State/Province

ZIP / Postal Code

Country

Website *

B. Lead Persons' Information

Potential Partner's Lead Person (External)

Title

Complete Name

Position/Designation

Specific Unit/Office

Email Address

Contact Number

BSU Lead Person (Internal) (if any)

Title

Complete Name

Position/Designation

Specific Unit/Office

Email Address

Contact Number

C. Detailed Description of Potential Partners

1. Quality Assurance & Accreditation/ Accreditation, Licensing, Registration Status

a. Accreditation/Registration/Licensing Status recognized by the competent government agencies/organization

Name

2. Complementarity and Compatibility with BSU

a. Vision and Mission

Vision

Mission

b. List Activities/Projects/Program1) Activities/Projects/Programs Supporting the Academic Sector

Program

Description

Beneficiary

Remarks

Source/Website

2) Activities/Projects/Programs Supporting the Research Sector

Title

Description

Beneficiary

Remarks

Source/Website

3) Activities/Projects/Programs Supporting the Extension Sector

Title

Description

Beneficiary

Remarks

Source/Website

4) Activities/Projects/Programs Supporting the Production Sector

Title

Description

Beneficiary

Remarks

Source/Website

3. International Partners/Linkages/Internationalization Programs

This may be used as an indicator to determine the potential partner’s commitment to provide internal funding.

a. List of International Partner/Linkages

Name of Partner

Description

Source/Website

b. List of Internationalization Programs

Program

Description

Source/Website

4. Cross Cultural and Inclusiveness Programs

This may be used to show recognition of, and respect for national differences, and efforts (e.g., gender, religion, cultural activities, disable access, outreach programs)

a. List of International Affiliations

Name

Description

Source/Website

b. Cross-Cultural and Inclusiveness Programs

Program

Description

Source/Website

5. List Sustainable Development Programs

a. List of SDG Programs

Program

Description

Source/Website

6. Proposed Programs/Projects/Activities for Collaboration with Potential Partner

Willingness to make collaborative decisions; and share responsibility and resources.

Please attach the draft of the agreement.

No file chosen

a. Tentative List of Partnership Programs between BSU and Potential Partner

Area of Collaboration *

Name of Program/Project/Activity

Objectives

Proposed Date

Expected Outcome

b. Initial Partnership Resources Information

Nature/Type

Internal Resources: BSU

Internal Resources: Potential Partner

External Resources

Prepared by:

Name

Position/Designation

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