Professional Staff Evaluation Form

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APPENDIX F
Professional Staff Evaluation Form
1.
Evaluation for:
Annual Review
Promotion
Tenure
Promotion and Tenure
2.
Covering the calendar year: ________________________________________________________
PART A
(To Be Completed by Faculty Unit Member)
Background Information
3.
Name: _________________________________________________________________________
Department: ____________________________________________________________________
Date: __________________________________________________________________________
Academic rank: ____________________________ and date granted: _____________________
Degrees in reverse chronological order:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Additional academic or professional education:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
APPENDIX F
Professional Staff Evaluation Form
1.
Evaluation for:
Annual Review
Promotion
Tenure
Promotion and Tenure
2.
Covering the calendar year: ________________________________________________________
PART A
(To Be Completed by Faculty Unit Member)
Background Information
3.
Name: _________________________________________________________________________
Department: ____________________________________________________________________
Date: __________________________________________________________________________
Academic rank: ____________________________ and date granted: _____________________
Degrees in reverse chronological order:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Additional academic or professional education:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Professional Experience
4.
Expectations, consistent with institutional policies and subject to the concurrence of the dean and
vice president, for faculty unit member performance with respect to teaching and academic
advising, research, scholarship and creative activity, and service during the evaluation period as per
comment of department head pursuant to Section 11.2(4).
5.
Describe your major assigned responsibilities during the evaluation period.
6.
Describe your major performance objectives during the current evaluation period.
7.
a.
List your significant contributions to teaching or cooperative extension activities.
(Appendix G of the BOR-COHE agreement contains a sample list.)
b.
List your significant contributions to academic advisement.
8.
List your significant contributions in research, scholarship or creative activity. (Appendix G of the
BOR-COHE agreement contains a sample list.)
9.
a.
List your significant contributions to the university. (Appendix G of the BOR-COHE
agreement contains a sample list.)
b.
List your significant contributions to your discipline or profession. (Appendix G of the
BOR-COHE agreement contains a sample list.)
c.
List your significant contributions to the community-at-large. (Appendix G of the
BOR-COHE agreement contains a sample list.)
10.
Proposed major performance objectives for the next evaluation period.
PART B
(To Be Completed by Immediate Administrative Supervisor)
11.
Professional Performance
a.
Indicate your assessment of the faculty unit member's performance by explaining whether,
consistent with contemporary standards of the institution, the faculty unit member
exceeded, achieved or fell short of the level of performance reasonably expected in a(n)
(indicate rank) with like tenure status and comparable professional responsibilities and
resources. The explanation must indicate the consideration given to rank, experience and
tenure status, professional responsibilities and resources. Separate ratings must be given
for teaching, including separate mention of academic advisement, research and service
responsibilities. In each instance, based on the information supplied by the faculty unit
member, the supervisor must identify the specific activities, or lack thereof, that warrant the
rating.
b.
For all faculty unit members who serve on tenure track contracts or who hold rank below
that of professor, comment about progress towards achieving the levels of performance
that, in keeping with institutional standards, justify a recommendation for promotion to a
more senior rank or award of tenure. Comments must address each area of professional
responsibility.
c.
Where appropriate, include recommendations for augmentation monies and contract
renewal.
d. Response to the faculty unit member's major performance objectives for the next evaluation
period?
Signature of Supervisor: _________________________________________________________________
Date: _______________________
12.
I have received these comments and ratings from my immediate supervisor. I understand that I
have the right to respond to these comments and ratings in writing or to call upon a peer group to
review the evaluation, provided that notice of such intent is given to the department head within
five (5) working days after receipt of this document.
Signature of Faculty Unit Member: ________________________________________________________
Date: _______________________
13.
I should like to add:
Signature of Faculty Unit Member: ________________________________________________________
Date: ________________________
14.
I have reviewed these comments and ratings. I should like to add:
Signature of Dean or Vice President for Academic Affairs ______________________________________
Date: ________________________

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