Revised: December 2015
ADJUNCT F ACULTY
MINIMUM QUALIFICATIONS
EXCEPTION FORM
This request for exception to the minimum hiring qualifications is for Semester:
College requesting exception: _______________________________________
Name of adjunct faculty member: _____________________________________
Name of course to be taught: _______________________________________
Summary of adjunct faculty member’s credentials and/or work experience that would make this
person a viable instructor for the class:
Summary of the circumstances which currently require the college to make an exception to the
minimum hiring qualifications:
________________________________________________________________
Division/Department Chair Signature Date
Dean of Instruction Signature Date
_________________________________________________________ _________________________
Vice President’s Signature Date
_________________________________________________________ _________________________
President Signature Date
*This form must be completed with all signatures and in the adjunct faculty personnel file prior to the adjunct faculty being assigned as the instructor
of record in SIS.
[ ]
[ ] Denied
