Fillable Application for Emeritus Status (Napa Valley College)

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Application for Emeritus Status (Napa Valley College)

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The Application for Emeritus Status (Napa Valley College) form is 2 pages long and contains:

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  • 10 check-boxes
  • 19 other fields

Country of origin: US
File type: PDF

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Application for Emeritus Status
Applicant Information
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment
State
ZIP Code
Home Phone:
( )
E-mail
Preferred Academic Title
Eligibility Information
Retirement Status: Retired
Not Retired
Name of school from which you retired: ________________________________________________________
Years served as full- time instructor/professor at Napa Valley College: ______________ to ______________
Emeritus Benefits
Please indicate which of the Emeritus privileges you would like (check all that apply):
Official document certifying emeritus status endorsed by the President of the Academic Senate.
A business card (and, if appropriate, identification card) which indicates emeritus status.
Listing with the faculty in all appropriate directories*
Listing with the faculty in the college catalogue*
Courtesy campus parking with a faculty sticker
A faculty library card allowing full use of Library & Learning Resource Center
Complimentary or reduced price admission to NVC performances and events, on the same basis as that
provided to other faculty.
The opportunity to visit classes, subject to the consent of the professor.
Use of recreational and social facilities of the college, on the same basis as that provided to other faculty.
*Four (4) year limit, must reapply to continue
I hereby authorize the Senate and its appointed committee on Emeritus Status to verify the above statements as it
deems necessary and useful for its determinations, gather information as it deems needful and useful.
I am acquainted with the rules and regulations governing the granting and holding of Emeritus Status at Napa
Valley College.
Signature: _________________________________________________ Date: _______________________
Academic Senate
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FACULTY BUSINESS COMMITTEE
FOR COMMITTEE USE ONLY:
Name of applicant: __________________________________________________________
Disposition: Granted Not Granted Modified
If granted:
Academic Title: ____________________________________________________
Effective as of: _________________________
Date of application: _________________________
Years served: _________________________
As of: _________________________
If not granted or modified: Reasons:
Signature: __________________________________ Date: __________________
Chair, Faculty Business Committee
Please return to:
Academic Senate office
Room 841
Tel: (707) 256-7685
Fax: (707) 253-3241
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Application for Emeritus Status (Napa Valley College)

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Completed 5 September 2020

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