Fillable Appendix O-1 Application for Initial Credentialing List the (Pensacola State College)

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Appendix O-1 Application for Initial Credentialing List the (Pensacola State College)

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2014 – 2015 CBA O-1
Appendix O-1
Application for Initial Credentialing
Name____________________________________ Department___________________________
Plan Start Date ____________________________ Plan Completion Date __________________
List the activities you have completed for each requirement. If an activity was not completed at
Pensacola State College, you must include documentation describing the event. College course
work must be accompanied by a transcript (copy) and course description.
I. New Faculty Orientation Date _______________________________
List the specific training activities completed:
Training Activity
_____________________________________ ____________________________________
_____________________________________ ____________________________________
_____________________________________ ____________________________________
_____________________________________ ____________________________________
II. Areas Requiring Demonstration of Competence*
A. Curriculum and Instruction
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
2014 – 2015 CBA O-2
B. Psychology of Learning
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
C. Tests and Measurements
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
D. The Community College
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
E. Classroom Management
2014 – 2015 CBA O-3
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
F. Learning Technologies
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
G. Issues Affecting Higher Education
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
H. Additional Training (if required)
Title or Brief Description Clock Date Location
2014 – 2015 CBA O-4
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
III. New Faculty Mentoring Program
Name of Mentor________________________________________________________
Mentor’s Department____________________________________________________
The faculty member understands that the Initial Credentialing Plan is an initial Faculty
Development Plan (FDP) for the first three years of employment. A faculty member will not
be eligible for continuing contract nor promotion unless all the requirements of the Initial
Credentialing Plan have been met.
Faculty Member__________________________________ Date____________________
Immediate Supervisor______________________________ Date____________________
Next Level Supervisor______________________________ Date____________________
V.P. of Academic Affairs___________________________ Date____________________
* Supervisor’s must include a justification when approving credit for prior work/experience.
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Appendix O-1 Application for Initial Credentialing List the (Pensacola State College)

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Completed 23 July 2020

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