Section A: General Information
(to be completed by the candidate)

Candidate Details

• Name:
• School/Department:
• Telephone extension:  
• E-mail address:  
• Date of appointment or last promotion:

Earned Degrees

Earned degrees received in chronological order beginning with the most recent (specify date, subject, institution and grade of Honours):

Other Qualifications

Other qualifications received in chronological order beginning with the most recent (e.g. professional qualifications, honorary degrees):

Awards and Distinctions

Awards and distinctions in chronological order beginning with the most recent since your appointment:

Career Summary

Career to date, including any previous appointments in the University (e.g., as Contract Lecturer), in chronological order beginning with the most recent:

Special Considerations

List any special considerations which the Promotions Committee should take into account:

Areas of Performance

Indicate each area in which you consider your performance to be strong (one area must be teaching or research):

• Teaching
• Research
• Service to the University
• Service to the discipline/community

Peer Reviewers

List the names and full addresses (including telephone number and email address) of three Peer Reviewers who can comment on your performance in the areas listed. At least one Peer Reviewer (Teaching) and one Peer Reviewer (Research) must be listed. You must check that the Peer Reviewers are available and willing to provide reports before completing this application.

Short-listed candidates must provide the Secretary to the Committee with sufficient evidence (including a teaching profile) to enable the Peer Reviewers to complete their reports.

• Peer Reviewer(s) (Teaching):
  
• Peer Reviewer(s) (Research):
  
• Peer Reviewer (Service to the University):
  
• Peer Reviewer (Service to the discipline or the community):
  

Section B: Teaching
(to be completed by the candidate)

Courses Taught

List courses taught since advancement beyond the Merit Bar (use indicated format). Indicate with "*" those courses for which you are the only Lecturer or for which you are the Coordinator. Indicate with "**" those courses you have designed yourself. Include both undergraduate and postgraduate courses.

Postgraduate Student Supervision

Indicate the number and level of postgraduate students supervised since appointment or last promotion.

Postgraduate Awards Completed

• PhD:

  Student	Date of Award	Individual or joint supervision

• Research Masters:

  Student	Date of Award	Individual or joint supervision

• Taught Masters:

  Student	Date of Award	Individual or joint supervision

Current Postgraduate Students

Other Teaching Responsibilities

List any other teaching responsibilities (teaching consultancies etc.):

Approaches to Teaching

Give an account of your philosophy of teaching and learning including reasons why you choose your methods of instruction and assessment. Discuss any innovations you have introduced into your teaching and indicate areas where you have displayed leadership.

Student Feedback

Comment on any student feedback received and on how you used that feedback to improve your teaching (student feedback results may be included as an attachment to this form):

Professional Development

List any professional development activities you have undertaken to help you improve your teaching: