MASTER.FORM (1) 8/03
SOUTHERN ILLINOIS UNIVERSITY NAME: RANK: ACADEMIC UNIT: COLLEGE OF APPLIED SCIENCES AND ARTS This statement is to certify that I am aware of the entire contents of this dossier. Signature of Candidate Date
MASTER.FORM (2) 8/03
SOUTHERN ILLINOIS UNIVERSITY Name Rank Academic Unit is , is not recommended for promotion to the rank of or is , is not recommended for tenure
Department Chair Date is , is not recommended for promotion to the rank of or is , is not recommended for tenure
Dean Date
MASTER.FORM (3) 8/03
TABLE OF CONTENTS SECTION I: BASIC INFORMATION SECTION II: DEAN'S LETTER OF RECOMMENDATION SECTION III: DEPARTMENT CHAIR'S LETTER OF RECOMMENDATION SECTION IV: EVIDENCE AND EVALUATION REGARDING QUALITY OF
TEACHING A. Student Evaluation of Teaching B. Peer Evaluation of Teaching C. Other Evidence SECTION V: EVIDENCE AND EVALUATION OF RESEARCH A. Research/Creative Activities B. Funded Research C. Peer Evaluation D. Other Evidence SECTION VI: EVIDENCE AND EVALUATION OF PROFESSIONAL CONTRIBUTIONS A. Basic Academic Unit B. College or School C. University D. Discipline-Related E. Other Evidence SECTION VII: OTHER SUPPORTIVE MATERIALS
MASTER.FORM (4) 8/03
SECTION I
BASIC INFORMATION
SECTION I
BASIC INFORMATION I. Information on Candidate at time of Employment A. Date of Employment B. Rank and Title C. Highest Degree D. Terminal Degree Required for this Position E. Special Qualifications F. Professional Experience
MASTER.FORM (5) 8/03
G. Changes Subsequent to Employment 1. Degrees Completed University Degree Date Conferred 2. Other Professional Achievements H. Promotions Granted 1. Date From (rank) To 2. Date From (rank) To 3. Date From (rank) To I. Nature of Assignments Since Last Promotion J. Attach Completed Up-To-Date Vita
MASTER.FORM (6) 8/03
SECTION II
DEAN'S LETTER OF RECOMMENDATION
MASTER.FORM (7) 8/03
SECTION III
DEPARTMENT CHAIR'S LETTER
OF RECOMMENDATION
MASTER.FORM (8) 8/03
(Date) Promotion and Tenure Committee SIU School of Medicine Dear Committee Members: The Department of ___(name)_________ recommends the promotion and tenure (if applicable) of (name) to the rank of (title) with tenure (if applicable). The total number of voting faculty in the Department Review Committee was (number) . The vote of the Department review committee was as follows:
Number of Votes for Each Category of Performance Ranking** Teaching Research Service
Outstanding Effective
Not effective Not applicable** **Provide a rationale below for any category deemed not applicable.
Sincerely, (Department Chair) (Title)
MASTER.FORM (9) 8/03
SECTION IV
EVIDENCE AND EVALUATION REGARDING
QUALITY OF TEACHING
MASTER.FORM (10) 8/03
SECTION IV
EVIDENCE AND EVALUATION REGARDING
QUALITY OF TEACHING Information and evidence relating to quality of teaching during the period with the program are provided in this section. A. Student Evaluation of Teaching B. Peer Evaluation of Teaching C. Other Evidence
MASTER.FORM (11) 8/03
A. Student Evaluation of Teaching
MASTER.FORM (12) 8/03
TEACHING Summer 2008 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Spring 2008 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Fall 2007 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
MASTER.FORM (13) 8/03
Summer 2007 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Spring 2007 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Fall 2006 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Summer 2006 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
MASTER.FORM (14) 8/03
Spring 2006 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Fall 2005 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Summer 2005 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
MASTER.FORM (15) 8/03
Spring 2005 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Fall 2004 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Summer 2004 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
MASTER.FORM (16) 8/03
Spring 2004 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
Fall 2003 Course No.
Evaluation Reports by Students Teaching Load
Instructor Characteristics
Course Structuring by
Instructor
Enrollments Semester Hours Contact Hours
MASTER.FORM (17) 8/03
B. Peer Evaluation of Teaching
MASTER.FORM (18) 8/03
C. Other Evidence
MASTER.FORM (19) 8/03
C. Other Evidence 1. Direct Teaching 2. Development of Instructional Materials 3. Professional Development
MASTER.FORM (20) 8/03
SECTION V
EVIDENCE AND EVALUATION OF RESEARCH
MASTER.FORM (21) 8/03
SECTION V
EVIDENCE AND EVALUATION OF RESEARCH Information and evidence relating to research/creative activities during the period with the program are provided in this section. A. Research/Creative Activities B. Funded Research (and Training Grants) C. Other Evidence
MASTER.FORM (22) 8/03
A. Research/Creative Activities
MASTER.FORM (23) 8/03
MASTER.FORM (24) 8/03
MASTER.FORM (25) 8/03
SECTION V
EVIDENCE AND EVALUATION OF RESEARCH A. Research/Creative Activities
The scale is to be used with the following definitions: Evaluate the reputation of the source publishing the results of the research or (Please adapt for creative activity.) standard for creative exhibition or performance by checking the appropriate box below the section titled Department Chair’s professional assessment. 5 = Outstanding recognition in field, highly prestigious Include only those publications or activities that have occurred since last 4 = Highly respected in field promotion. 3 = Good reputation, selective 2 = Average, fairly easy to publish in or present to 1 = Low quality, not discriminating 0 = Lacking in quality X = No basis for judgment
Author(s) B
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Specify: Title, Association, Publisher, Journal or Place of Presentation
Date
Department Chair's Professional Assessment. Place Appropriate Number & Comments.
MASTER.FORM (26) 2/04
Author(s) B
ook
Boo
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Pape
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Specify: Title, Association, Publisher, Journal or Place of Presentation
Date
Department Chair's Professional Assessment. Place Appropriate Number & Comments.
MASTER.FORM (27) 8/03
Author(s) B
ook
Boo
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Pape
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Peer
rev
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Specify: Title, Association, Publisher, Journal or Place of Presentation
Date
Department Chair's Professional Assessment. Place Appropriate Number & Comments.
MASTER.FORM (28) 8/03
B. Funded Research
MASTER.FORM (29) 8/03
MASTER.FORM (30) 8/03
B. Funded Research
Principal Investigator(s) Title Purpose of Project Length of Project Amount Funded Funding Agency
MASTER.FORM (31) 8/03
MASTER.FORM (32) 8/03
C. Other Evidence
MASTER.FORM (33) 8/03
C. Other Evidence
MASTER.FORM (34) 8/03
SECTION VI
EVIDENCE AND EVALUATION OF PROFESSIONAL CONTRIBUTIONS
MASTER.FORM (35) 8/03
SECTION VI EVIDENCE AND EVALUATION OF PROFESSIONAL CONTRIBUTIONS Information and evidence relating to professional contributions during the period with the program are provided in this section. The professional contributions have been described on the following pages and are divided into four categories depending upon the area served. A. Basic Academic Unit B. College or School C. University D. Discipline-Related E. Other Evidence of Professional Contributions
MASTER.FORM (36) 8/03
A. Basic Academic Unit
MASTER.FORM (37) 8/03
SECTION VI
EVIDENCE AND EVALUATION OF PROFESSIONAL CONTRIBUTIONS
A. Basic Academic Unit
MASTER.FORM (38) 8/03
B. College or School
MASTER.FORM (39) 8/03
B. College or School
MASTER.FORM (40) 8/03
C. University
MASTER.FORM (41) 8/03
C. University
MASTER.FORM (42) 8/03
D. Discipline-Related
MASTER.FORM (43) 8/03
D. Discipline-Related
MASTER.FORM (44) 8/03
E. Other Evidence of Professional Contributions
MASTER.FORM (45) 8/03
E. Other Evidence of Professional Contributions
MASTER.FORM (46) 8/03
SECTION VII
OTHER SUPPORTIVE MATERIALS
