Minimum Time-In-Rank Eligibility Requirement
Professional Preparation Eligibility*
Eligibility Based on Supervisor Evaluations*
(attach overall evaluation forms or supervisor summary sheets)



*Application for Meritorious Commendation:*
VERIFICATION OF ELIGIBILITY FOR MERITORIOUS COMMENDATION


Applicant’s Name __________________________________________________________
Division________________________________________Date___________________

Minimum Time-In-Rank Eligibility Requirement

Present Rank_____________________________________________________________
Date of Last Promotion (or Hiring) ____________________________________

(attach documentation)

Professional Preparation Eligibility*

Teaching Discipline_________________________________________________________________

Minimum Credentials Held (yes/no)______________________________________

Academic Areas only: Number of Graduate Credits in Discipline_________________

Eligibility Based on Supervisor Evaluations*

Supervisor Evaluations indicate a rating of “4,” or “4.5,” or “5” for the last three consecutive academic years*

(yes/no)____________________________________________________

(attach overall evaluation forms or supervisor summary sheets)

The applicant meets the minimum Time-in-Rank requirements, Professional Preparation Eligibility requirements, and Eligibility Requirements based on Annual Supervisor Evaluations.

Yes________________ No_____________________

Reason (if no)__________________ __________________________________________

Signature of Academic Dean Date

* After academic dean has verified eligibility, this form and all attached documentation will be returned to the applicant. Only the Overall Evaluation Forms or Supervisor Evaluation Summary Sheets (for academic years 2023-2024) are to be included in the applicant’s portfolio.

Form 2321/001A (5/24)