Application Form 2019/2020Please select the programme you wish to apply for:

Postgraduate Certificate in Academic Practice (PGCAP) ☐Advancing Teaching: Lancaster Accreditation Scheme (ATLAS) ☐Please complete all the sections of this form as fully as you can, expanding boxes as needed. We acknowledge this is a long form and appreciate your completing it. The information is used to help us fairly allocate places on the programme you have applied for, and to help ensure that the most appropriate development pathways are selected based on individual needs and experience.

General Data Protection Regulations (GDPR): The University will process your personal data in accordance with GDPR, further details can be found on the Lancaster University website under Privacy notice for staff/workers at Lancaster University. Your personal data will be shared with Advance HE when registering an award of HEA Fellowship and will be kept in accordance with Advance HE Privacy Policy.

To request an accessible format of this application form please contact us at ed@lancaster.ac.uk SURNAME / FAMILY NAME OTHER NAMES (IN FULL) PREFERRED NAME

TITLE (Mr, Ms, Dr, etc) GENDER DATE OF BIRTH NATIONALITY

DEPARTMENT WORK TELEPHONE/MOBILE LANCASTER UNIVERSITY EMAIL

YOUR PERSONAL EMAIL* (PGCAP applicants only)

*Required for LUSI registration

PLEASE INDICATE ANY PHYSICAL OR OTHER DISABILITIES WHICH MAY NECESSITATE SPECIAL ARRANGEMENTS

QUALIFICATIONS AND COURSESPlease provide a summary of qualifications and certificated/accredited courses, including any that have contributed to your teaching development (also include Lancaster ATP /PGCAP here)

DATESFT/ PT

INSTITUTION ATTENDED QUALIFICATIONFROM MM/YY

TOMM/YY

EMPLOYMENT IN HIGHER EDUCATIONPlease provide a brief outline, in chronological order, of employment within the HE sector prior to and including your appointment at Lancaster

DATESFTE INSTITUTION ROLE

FROM MM/YYTO

MM/YY

For an accessible format of this application form please contact us as ed@lancaster.ac.uk

Additional comments: If your employment with Lancaster University is fixed term or casual, will your contract end within the next:

6 months ☐ Comment:

9 months ☐ Comment:

12 months ☐ Comment:

TEACHING ROLES AND RESPONSIBILITIES FOR THE FORTHCOMING ACADEMIC YEAR For PGCAP applicants: provide details as far as you are able to do so at this stage. Please see FAQs section for teaching responsibilities required to undertake PGCAP

BRIEF EXPLANATION OF ACTIVITYe.g. Module titles, level and credits; Course design and development activity; Student-facing support activity

APPROX CONTACT HOURS

TERM teaching undertaken

COURSE DESIGN RESPONSIBILITIESe.g. Designed new; Updated Existing; Content authoring; Assessment Setting; Individual or part of design team

MAIN MODES OF TEACHING

TYPICAL CLASS SIZE

SUMMARY OF PRIOR TEACHING / LEARNING SUPPORT EXPERIENCEBRIEF EXPLANATION OF ACTIVITYe.g. Module titles, level and credits; Course design and development activity; Student-facing support activity

APPROX CONTACT HOURS

COURSE DESIGN RESPONSIBILITIESe.g. Designed new; Updated Existing; Content authoring; Assessment Setting; Individual or part of design team

# OF YEARS YOU TAUGHT ON THIS COURSE

TYPICAL CLASS SIZE

OTHER TEACHING RELATED ADMINISTRATIVE RESPONSIBILITIES AND EXPERIENCEDATES TEACHING RELATED RESPONSIBILITIES e.g. Faculty, Departmental or Professional Service Rep,

Module Leader, PhD Supervisor, Admissions Tutor, Exams Officer, Teaching Committee Rep, Part 1 Director etcFROM TO

ASSOCIATED PROFESSIONAL ACTIVITYHave you been involved in any of the following:

ACTIVITY BRIEF DESCRIPTION

Involvement in peer review of teaching (e.g. peer observations, team teaching, course planning and review meetings)

Mentoring and coaching colleagues to support teaching and learning

Undertaken teaching development projects (e.g. national, institutional initiatives)

Scholarship of learning and teaching (this may include publications related to teaching in your discipline)

Self-initiated professional development for teaching (e.g. using feedback from students, membership of teaching networks, conferences, reading relevant literature, piloting innovative teaching methods)

Been awarded a prize or award for teaching

AREAS FOR DEVELOPMENTBriefly explain any aspects of your educational practice you would be interested to develop during the programme

Current Fellowship Status

☐ N/A ☐ Associate Fellow ☐ Fellow ☐ Senior Fellow

If you do not know your current Fellowship status you can check by contacting the Advance HE

For ATLAS applicants *only*TARGET FELLOWSHIP STATUS☐ Associate Fellow☐ Fellow☐ Senior FellowIMPORTANT: PLEASE NOTE THAT YOUR ATLAS SUBMISSION IS EXPECTED WITHIN 12 MONTHS OF YOUR APPLICATION BEING ACCEPTED.

Does participation on the programme form part of your probationary agreement?

☐ Yes, it is part of my probationary agreement (please ensure your department completes the statement of support)

☐ No, it is not part of my probationary agreement

If yes, please ask your department to complete the appended statement of support and return this along with the rest of your registration form. If no, please ensure you complete the relevant section below to advise us of who your Departmental Teaching Mentor will be. If yes, what is the probationary agreement? By when are you expected to have completed?

I certify that I have completed this registration form myself, and that the information I have given is correct.

SIGNED DATE

Disclaimer: upon successful completion of your target, you will have the opportunity to become a critical friend in your department. The ED team will be in touch to explore ways in which you could be involved to support your colleagues in achieving their future professional development goals.

Departmental Statement of SupportThis section should normally be completed by the Head of Department, or nominated other if appropriate.

This section must be completed if the application is part of a probationary agreement. However, it may be useful for the Head of Department to complete this form in other cases, so departments are aware of the time commitment associated with this scheme. Further details on the commitments can be found on the relevant programme websites under the Frequently Asked Questions tab (PGCAP FAQs and ATLAS FAQs).

Programme places are prioritised for colleagues who are participating as part of their probationary agreement. Depending on individual colleagues’ experience and prior teaching development, alternative pathways of development leading to teaching qualifications and/or professional recognition may be recommended. The following criteria generally applies:

For colleagues with less than 3 years HE teaching experience in a full academic role, to join PGCAP. This is a developmental route to professional recognition and requires reflection on developing practice.

For colleagues with more than 3 years of HE teaching and/or supporting learning experience, and currently not holding a HEA fellowship, to offer a place on the ATLAS CPD scheme. This is an experienced-based pathway leading to professional recognition for teaching in HE and requires reflection on previous practice.

Departmental Teaching Mentorship (PGCAP)PGCAP participants must be allocated a teaching mentor in their department. Mentors must undertake

observation of their mentees practice to authenticate that it meets the requirements of HEA Fellowship. The mentor is an essential role to help participants draw on their own experience to contextualise the learning. We recommend that mentors are identified in consultation with the individual participant, as this tends to make for a more productive relationship. PGCAP graduates often make excellent mentor’s as they are very familiar with the process and ethos of the programme, as well as being familiar with the requirements for HEA Fellowship. Mentors will be invited to attend a mentor induction session on either Tuesday 17th September 2019, 9.30-11.30 am or Thursday 19th September 2019, 2 - 4 pm. This will provide mentors with an overview of the PGCAP, the requirements for HEA Fellowship and the role of the mentor. Please see the Mentor handbook for further details.

With regard to ATLAS, the scheme increasingly benefits from collegial approach for applicants and achievers professional development, for that we encourage the departmental ATLAS mentoring and/or critical friendship.

Please discuss the application with the participant, ensuring that you both agree about the commitment involved, then complete the agreement below.

NB The prioritisation of a place cannot be guaranteed without a signed statement of support/departmental confirmation:

The department supports to join the chosen CPD scheme/programme. ☐This colleague is required to complete the programme as part of their probationary agreement, and this requirement has been explicitly factored into the workload allocation. ☐

It is acknowledged that successful completion of the programme requires attendance scheduled sessions, but also some study, reading and writing over and beyond the attendance. This time commitment has been negotiated between us.

☐

The applicant will have a sufficient range of teaching and related academic duties during the year to complete the programme (PGCAP only) ☐

The department confirms that a suitable teaching mentor has been identified (PGCAP only) and they are able to undertake peer observation as outlined in the mentor handbook. Name of Departmental Teaching Mentor:

☐

HEAD OF DEPARTMENT SIGNATURE (or nominee) DATE

For further information and/or clarification, please contact ed@lancaster.ac.uk ./tt/file_convert/5d49104288c993d82b8bd051/document.docx