Arkansas Tech University
FACULTY RECORD
Please complete, print, sign, attach a copy of all vita, and mail to Academic Affairs in Administration, Room 200.
Please note: the completed form is a required element of your personnel file; the vita will provide supplementary documentation.
Name: Office Phone:
Position: Department:
Undergraduate Degree
Institution: Dates Attended: to
Degree: Date Degree Granted:
Major: Sem. Hrs:
Minor: Sem. Hrs:
Graduate Degree(s)
Institution: Dates Attended: to
Degree: Date Degree Granted:
Major: Sem. Hrs:
Minor: Sem. Hrs:
Institution: Dates Attended: to
Degree: Date Degree Granted:
Major: Sem. Hrs:
Minor: Sem. Hrs:
Institution: Dates Attended: to
Degree: Date Degree Granted:
Major: Sem. Hrs:
Minor: Sem. Hrs:
Institution: Dates Attended: to
Degree: Date Degree Granted:
Major: Sem. Hrs:
Minor: Sem. Hrs:
Teaching Experience
Institution: Dates: to
Position: Years: to
Institution: Dates: to
Position: Years: to
Institution: Dates: to
Position: Years: to
Other Experience
Employer: Dates: to
Position:
Employer: Dates: to
Position:
Employer: Dates: to
Position:
Military Service: Dates: to
Signature Date