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2020-2021 Returning Participant Agreement

College of Arts and Sciences Publisher in Residence Program

This form is for faculty and instructors who are returning participants seeking to complete their required follow-up meetings, or for those who have participated in the past and would like to schedule a meeting to discuss on-going projects.

Please answer the following questions:

1. Would this meeting be one of your two follow-up meetings required by the Participant Agreement? Yes or No

2. Have you completed your required follow-up meetings and still desire additional consultations? Yes or No

Please list the title of the project(s) you are working on with the program, the progress made over the past year, and indicate if each is currently in-progress, submitted, revise & resubmit, accepted or published over the last academic year:

Requirements: Scheduling additional meetings past the required two follow-up meetings is contingent upon your ability to show progress on your projects. If there is not sufficient progress toward publication, the Dean’s Office reserves the right to suspend your meetings with the consultant.

I, ____________________________have read and understand the requirements pertaining to continued

Faculty Member PRINTED NAME participation in the Publisher-in-Residence program.

_____________________________________ ___________________________________

Faculty Member Signature Date Faculty Member Rank/Title

______________________________________ ___________________________________

Email Phone Number

______________________________________ ___________________________________

Department Chair Signature Date College Associate Dean’s Signature

Please return this signed form with your chair signature to Leslie Wiggins at ljwiggins@ua.edu and direct questions to Lisa Dorr at Lisa.Dorr@ua.edu .

Distribution List:

College Personnel File

Department Chair

Lisa Dorr, Associate Dean

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