Academic Promotion Application Template – to Level B



Application must be double-sided.Section 1:Application FormPersonal DetailsTitle FORMTEXT ?????Surname FORMTEXT ?????First Name FORMTEXT ?????E-mail Address FORMTEXT ?????Correspondence Address FORMTEXT ?????Appointment DetailsPosition Title FORMTEXT ?????Current Academic Level FORMTEXT ?????School/Directorate FORMTEXT ?????Portfolio FORMTEXT ?????Campus FORMTEXT ?????Date of Initial Appointment FORMTEXT ?????Date of Appointment/Promotionto Current Academic Level FORMTEXT ?????Continuing or Fixed-term Appointment (include expiry date) FORMTEXT ?????Current Fraction FORMTEXT ?????Length of Service at the University FORMTEXT ?????Have you successfully completed your probationary period? FORMTEXT ?????Academic Level Applied ForLevel C FORMCHECKBOX Level D FORMCHECKBOX Level E FORMCHECKBOX Levels of Achievement ClaimedRefer to Academic Promotion Procedure for Levels C, D and EMeritoriousOutstandingDistinguishedHigh DistinguishedLeadership and Engagement FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Additional APPLICANT InformationYesNoDoes your promotion application include a case of achievement relative to opportunity? FORMCHECKBOX FORMCHECKBOX Does your promotion application include approval of equivalent accreditation and standing status? FORMCHECKBOX FORMCHECKBOX Please print name FORMTEXT ?????SignatureDate FORMTEXT ?????Contact Extension No. FORMTEXT ?????Privacy Collection statement Information on this form is collected for the primary purpose of assessing an application for academic promotion; communicating with the applicant; attending to administrative matters; de-identified statistical analysis; and disclosure to the promotions committee.By signing this application, you consent to the information contained in it to be disclosed and used as described.Section 2:Case for PromotionSection 2.1:Summary Statement of Key AchievementsThis should be a case for promotion argued according to the criteria for the level of promotion being sought. It should be written as a succinct overview statement highlighting key achievements. Note that Section 4, Professional Folios, provides the opportunity to discuss in detail and to cite evidence in support of these achievements, and to provide critical reflection.Maximum word lengths are as follows:1,000 words for Level C applications.1,500 words for Level D applications.2,000 words for Level E applications. NUMWORDS 0 FORMTEXT ?????Word Count: NUMWORDS 0Section 2.2:Discipline Context Summary(Maximum word length is 250 words)Provide a context summary of your discipline/research area. (e.g. opportunities and challenges) FORMTEXT ?????Word Count: FORMTEXT ?????Section 2.3:Case for Achievement Relative to Opportunity(Maximum word length is 800 words)Applicants may outline work arrangements and special circumstances, and their impact on career progression and performance. Please refer to Academic Promotion Policy. FORMTEXT ?????Word Count: FORMTEXT ????? NUMWORDS 0Section 3:Curriculum VitaeThis template is provided to assist applicants and provides a preferred format, however you may adjust or add to the sub-headings and extend spaces provided for information. Your curriculum vitae should not exceed three pages in length.Academic QualificationsFormal QualificationsYearQualificationUniversityOther QualificationsYearQualificationInstitutionFurther Study being UndertakenExpected completion date:Expected completion date:AppointmentsCurrent AppointmentYearPositionLocationPrevious AppointmentsYearPositionOrganisationAcademic/Professional Awards and DistinctionsAcademic/Professional Association Memberships/RolesSection 4:Professional FolioIntroduction:The Professional Folio is a structured format for presentation of supporting evidence in the area of Leadership and Engagement, and a commentary on the quality and impact of achievements.Original documents and records must be submitted to Human Resources preferably in an electronic format.Templates provided are to assist preparation of supporting evidence and represent the preferred format; however applicants may adjust or add to sub-headings as required and within the advised word limit.Section 4.1:Professional Folio – Leadership and EngagementLeadership within the School and the UniversityThis may include committee membership and activity, special projects, serving as a representative of the University on external bodies, liaison with industry representatives, service to professional associations or discipline related groups.DateDescription of RoleEngagement ActivityThis may include professional service, practice based research, project leadership with community partners, problem solving, policy development, change management, public education and advocacy funded projects, and entrepreneurial activity leading to outcomes for the discipline, School, University or community.DateDescription of RoleSummary of Major Leadership and Engagement Responsibilities and Initiatives(up to 1,000 words) FORMTEXT ?????Word Count: FORMTEXT ????? NUMWORDS 0Critical and reflective commentary on activity and achievement in Leadership and Engagement and where appropriate the integration of teaching, research and educational leadershipThis section provides an opportunity to discuss activity and achievement against the criteria for promotion.Include, for example, recent reading in learning and teaching, a discussion on how research informs your teaching, discussion of evaluative feedback from peers and students. Identify significant activity in areas such as innovative teaching practices, curriculum development, assessment, development of flexible/blended delivery courses, response to student feedback and effectiveness in promoting student learning.Maximum word lengths are as follows:1,800 words for Level C applications.2,250 words for Level D applications.2,000 words for Level E applications. FORMTEXT ?????Word Count: FORMTEXT ????? NUMWORDS 0Section 5:RefereesApplicants to Levels C, D and E must nominate up to three referees. At least one referee must be external to the University for applications to Academic Level C, at least two referees must be external to the University for applications to Academic Level D, and at least two referees must be external to the University and at least one of the external referees must be an international referee for applications to Academic Level E.Title FORMTEXT ?????Name FORMTEXT ?????E-mail Address FORMTEXT ?????Postal Address: FORMTEXT ?????Suburb/Town: FORMTEXT ?????State: FORMTEXT ?????Post Code: FORMTEXT ?????Phone Number: FORMTEXT ?????Fax Number: FORMTEXT ?????Why referee was chosen: FORMTEXT ?????Internal Referee FORMCHECKBOX External Referee FORMCHECKBOX International Referee FORMCHECKBOX Title FORMTEXT ?????Name FORMTEXT ?????E-mail Address FORMTEXT ?????Postal Address: FORMTEXT ?????Suburb/Town: FORMTEXT ?????State: FORMTEXT ?????Post Code: FORMTEXT ?????Phone Number: FORMTEXT ?????Fax Number: FORMTEXT ?????Why referee was chosen: FORMTEXT ?????Internal Referee FORMCHECKBOX External Referee FORMCHECKBOX International Referee FORMCHECKBOX Title FORMTEXT ?????Name FORMTEXT ?????E-mail Address FORMTEXT ?????Postal Address: FORMTEXT ?????Suburb/Town: FORMTEXT ?????State: FORMTEXT ?????Post Code: FORMTEXT ?????Phone Number: FORMTEXT ?????Fax Number: FORMTEXT ?????Why referee was chosen: FORMTEXT ?????Internal Referee FORMCHECKBOX External Referee FORMCHECKBOX International Referee FORMCHECKBOX Section 6:Executive Dean’s Report The Executive Dean is required to prepare an evaluative report that addresses the merits of the applicant’s case with reference to the levels of achievement claimed by the applicant and comment on the referees chosen. This report must be typed.Executive Dean’s DetailsTitle and Full Name FORMTEXT ?????Division FORMTEXT ?????School/Portfolio FORMTEXT ?????Position Held FORMTEXT ?????Phone Extension FORMTEXT ?????E-mail Address FORMTEXT ?????Correspondence Address FORMTEXT ?????Executive Dean’s Comments on Leadership and Engagement FORMTEXT ?????Executive Dean’s Comments on Contribution to the Faculty and University’s Charter FORMTEXT ?????Executive Dean’s Comments on Case for Achievement Relative to Opportunity FORMTEXT ?????Any other information relevant to the application FORMTEXT ?????Executive Dean’s RecommendationThe case presented by this applicant is (place an x on the scale below to indicate support):50Strongly SupportedNot supportedProvide reasons for recommendation: FORMTEXT ?????Please print name FORMTEXT ?????Executive Dean’s SignatureDate FORMTEXT ?????Contact Extension No. FORMTEXT ?????Applicant is required to complete the following sectionI have read the contents of the Executive Dean’s report provided above as per Academic Promotion Procedure for Levels C, D and E.Please print name FORMTEXT ?????Applicant’s SignatureDate FORMTEXT ?????Contact Extension No. FORMTEXT ?????Applicant Response to the Executive Dean’s Report (optional)(Maximum word limit is 500 words) FORMTEXT ?????TYPES OF SUPPORTING EVIDENCE FOR APPLICATIONSExample of types of supporting evidence are below. Supporting evidence must be submitted with your application and preferably in electronic format (e.g. memory stick).Leadership and Engagement FORMCHECKBOX Committee membership FORMCHECKBOX Invitations to be on editorial boards FORMCHECKBOX Invitations to participate in community engagement activities/participation in relevant community groups/networks FORMCHECKBOX Industry reports FORMCHECKBOX Membership of professional associations FORMCHECKBOX Partnership reports FORMCHECKBOX Consultancy reports FORMCHECKBOX Provision of advice to governments, public service departments, industry or community groups FORMCHECKBOX Evidence of interaction in the public media FORMCHECKBOX Informing and contributing to public debate related to academic expertise FORMCHECKBOX Expert member on policy or advisory board FORMCHECKBOX Activities which raise the profile of the UniversityPlease note, these examples are not exhaustive.CHECKLIST FOR SUBMITTING APPLICATIONSHave you:Checked your eligibility?: FORMCHECKBOX Completed at least one year’s service at date of call? FORMCHECKBOX Successfully completed probationary period? FORMCHECKBOX Participated in PRDP? FORMCHECKBOX Hold a PhD or equivalent accreditation and pleted the application correctly and provided all required information?: FORMCHECKBOX Signed your applications in Section 1? FORMCHECKBOX Attached and provided your supporting evidence? (Preferably on a memory stick) FORMCHECKBOX Has the Executive Dean Report been included with recommendation selected and signed? FORMCHECKBOX Have you acknowledged and signed that you have read the Executive Dean’s report? FORMCHECKBOX Are your referees correctly nominated?:Level C – 3 referees, 1 external referee*.Level D – 3 referees, 2 referees external*Level E – 3 referees, 2 external and 1 external must be international.*External referee must not have been employed by FedUni during the three years preceding application closing date. ................
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