Fillable REQUEST FOR MEMBERSHIP IN THE GRADUATE FACULTY AT (Southeastern Louisiana University)

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REQUEST FOR MEMBERSHIP IN THE GRADUATE FACULTY AT (Southeastern Louisiana University)

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REQUEST FOR MEMBERSHIP IN THE GRADUATE FACULTY
AT SOUTHEASTERN LOUISIANA UNIVERSITY
* Please note that the Biographical Sketch form must accompany this request. For faculty
s
eeking initial appointment to graduate faculty, a SACS credential verification letter from the
department head must be accompany this request.
RECOMMENDATION
Signatures:
_Approved _ __Denied
Printed Name Departmental Committee Rep/ Date
_Approved __Denied
Printed Name Academic Department Head/ Date
_Approved __Denied
Printed Name College Dean/ Date
_Approved ____Denied
Printed Name Director of Graduate Studies/ Date
Revised 12/11/2018
Boxed information to be completed by applicant
Applicant’s Name: Date:
Applicant’s Signature:
Applicant’s Title:
Department and College:
Type of appointment requested (please check one):
_____ Full Graduate Faculty appointment
_____ Associate Graduate Faculty appointment
______Time limited appointment (appointment end date is 3 years from appointment date)
click to sign
signature
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BIOGRAPHICAL SKETCH for GRADUATE FACULTY APPOINTMENT or REAPPOINTMENT
Provide the following information.
DO NOT EXCEED THREE PAGES.
NAME
:
___
______________________________________________________________
POSITION TITLE
:
___
___________________________________________________________________
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing and include postdoctoral
training.)
INSTITUTION AND LOCATION
DEGREE
(if applicable)
YEAR(s) FIELD OF STUDY
_________________________________
_________________________________
___________________
_______
__________________________________
A. Positions and Honors.
Positions and Employment
(begin with current position)
__________________________________________________________________________________________
____
______________________________________________________________________________________
____
______________________________________________________________________________________
__________________________________________________________________________________________
Honors
____
______________________________________________________________________________________
____
______________________________________________________________________________________
__________________________________________________________________________________________
____
______________________________________________________________________________________
B. Peer-Reviewed Publications or Creative Works (list for last five (5) years only).
____
______________________________________________________________________________________
____
______________________________________________________________________________________
____
______________________________________________________________________________________
____
______________________________________________________________________________________
C. Graduate Student Training & Teaching (List for past five (5) years, courses taught, students
mentored as major advisor/professor or committee member)
__________________________________________________________________________________________
_______________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Ongoing Research & Creative Activity Support
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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REQUEST FOR MEMBERSHIP IN THE GRADUATE FACULTY AT (Southeastern Louisiana University)

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Completed 26 August 2020

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