California State University, Dominguez Hills
Request for Emeritus Faculty Status
Before completing this request, please carefully read PM2014-02.
Summary of Policy for Emeritus Faculty Status
Criteria – Retirement as full-time, tenured or lecturer faculty member with a minimum of ten (10) years of
service at the University; distinguished performance in one or more of the traditional areas of performance
evaluation; and favorable recommendation from faculty of retiree’s department.
Benefits for Emeritus Faculty – In addition to all benefits and privileges accorded University retirees: emeritus
identification card; listing in University Catalog and campus directory; participation in department meetings
and affairs, as appropriate; service as members of graduate thesis or project committees; office space,
administrative support and University resources, subject to availability; access to computer services and
campus rooms and facilities for meetings and reunions; free use of athletic facilities, as available to regular
faculty; free receipt of University publications, upon request; free or discount fees for all campus cultural and
athletic events; and free lifetime campus parking pass.
Instructions: Please provide all requested information. Append a current curriculum vita or resume. After
completion, submit materials to the department chair for the department faculty’s endorsement.
Name Dept.
First M.I. Last
Academic Year in which
Rank Tenure was Awarded
Employed full-time
at CSUDH since Retirement Date
Month Day Year Month Day Year
Summary – Significant Honors/Awards/Distinctions and Year in which Received, e.g., CSUDH Outstanding
Professor Award, Lyle E. Gibson Distinguished Teacher Award, honorary degree(s):
Signature Date
Street Address City, State & Zip
Telephone Number (Specify whether home or cell.) E-Mail Address
