INSTITUTIONAL ACCREDITATION
FACULTY INFORMATION FORM

Form to be completed for faculty designated by the department's review coordinator.
Directions:

Form to be completed for faculty designated by the department's review coordinator.
Note:    Some items may be completed by reference to an attached resume
 
Date:  

Institution:
Name:

Department:

  
Years at
Institution:
 		  

FT (new)

  

PT (new)

  

Tenured? (Yes or No)

  

                                                                                          Institution has no tenure system _________
1. CURRENT RESPONSIBILITIES AT THIS INSTITUTION:
a. Teaching
Teaching This Term:
(list each section)		 Credits Approx
Enroll		 Location if not
main campus		 Day(s) and time
Offered
         
         
         
         
         
         
         

b. Advising: Number of advisees: Undergraduate __________  Graduate __________
c. Other Assignments/Responsibilities (committees, etc., in last three years):
 





2. CURRENT RESPONSIBILITIES AT OTHER COLLEGES/SCHOOLS, COMPANIES, AGENCIES, ETC.
 
 
3. EDUCATION: (starting with most recent)
Degree Institution Date
Received		 Major/
Specialization		 Title of Research















 
4. OTHER PROFESSIONAL TRAINING/EXPERIENCE RELATED TO COURSES LISTED ABOVE
 


 
5. PRIOR TEACHING EXPERIENCES: (starting with those most pertinent to current teaching assignments at this institution)
  Institution Subjects Dates
       
 
 
 
 
6. ACTIVITY IN PROFESSIONAL ASSOCIATIONS:
 
 


7. PUBLICATIONS:
 
  1. a. Most Significant


  2. b. Recent (last 3-5 years)
8. OTHER SIGNIFICANT PROFESSIONAL ACCOMPLISHMENTS
 
 


9. EVALUATION OF TEACHING AND OTHER RESPONSIBILITIES BY COLLEGE
 
  1. a. What are this institution's policies on evaluation of faculty?








  2. b. Describe this institution's support of your professional development in the past five years.

Office of College and University Evaluation Attention: Accreditation
State Education Department, 89 Washington Avenue, 5 North Mezzanine
Albany, NY 12234  Phone: (518) 474-2593  Fax: (518) 486-2779
E-mail: bmeinert@mail.nysed.gov