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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2018 – 2021 CBA O-1 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 Completed _____________________
List the specific training activities completed:
Training Activity
_____________________________________ ____________________________________
_____________________________________ ____________________________________
_____________________________________ ____________________________________
_____________________________________ ____________________________________
II. Areas Requiring Demonstration of Competence* (6 hours required)
A. Curriculum and Instruction
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
2018 – 2021 CBA O-1 2
B. Psychology of Learning (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
C. Tests and Measurements (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
D. The Community College (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
2018 – 2021 CBA O-1 3
E. Classroom Management (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
F. Learning Technologies (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
G. Issues Affecting Higher Education (6 hours required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
2018 – 2021 CBA O-1 4
H. Additional Training (if required)
Title or Brief Description Clock Date Location
Hours (if not College)
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
______________________________ _______ ________ _____________
I. New Faculty Cohort Meetings
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 and Student 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 25 August 2020

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