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VERIFICATION OF ELIGIBILITY
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FOR PROMOTION (Part A of Application)*
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Applicant’s Name __________________________________________________________
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Division________________________________________Date___________________
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Minimum Time-In-Rank Eligibility Requirement
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Present Rank_____________________________________________________________
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Date of Last Promotion (or Hiring) ____________________________________
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(attach documentation)
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Professional Preparation Eligibility*
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Teaching Discipline_________________________________________________________________
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Minimum Credentials Held (yes/no)______________________________________
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(attach transcripts)
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Academic Areas only: Number of Graduate Credits in Discipline_________________
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Eligibility Based on Supervisor Evaluations*
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Supervisor Evaluations indicate a rating of “4” or “5” for the last three consecutive academic years*
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(yes/no)_________________________________________
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(attach summary sheets)
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The applicant meets the minimum Time-in-Rank requirements, Professional Preparation Eligibility requirements, and Eligibility Requirements based on Annual Supervisor Evaluations.
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Yes________________ No_____________________
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Reason (if no)__________________ __________________________________________
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Signature of Division Dean
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* After Division Dean has verified eligibility, this form and all attached documentation will be returned to the applicant. Only the Supervisor Evaluation Summary Sheets are to be included in the applicant’s portfolio. College transcripts are NOT to be included.
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Form 2321/001A (8/21)
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VERIFICATION OF DOCUMENTATION
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for Promotion Criteria (Part B of Application)
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Documented Performance Ability
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If supervisor's evaluations cannot be submitted for the last three consecutive academic years, explain the circumstances for each missing evaluation.
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Supervisor Evaluations
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Missing Year
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Missing Year
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______________________________________________________________________
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Signature of Applicant
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______________________________________________________________________
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Signature of Division Dean
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Form 2321/001B (8/21)
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Promotion Portfolio Routing Sheet
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(Part C of Application)
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Required Format of the Promotion Portfolio
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Yes
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Title Page - indicating name of applicant and rank applied for
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Table of Contents
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Verification of Eligibility Form, Form 2321/001A
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Verification of Documentation Form, Form 2321/001B
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