Emeritus Appointment/Extension of Service

The Emeritus Appointment/Extension of Service Form (PDF) is to be used for recommending the promotion of a faculty member to Emeritus status, and/or to extend the appointment of a retired faculty member. The initial Extension of Service action requires Provost approval only.

In addition to the completed form, please attach:

  • a memorandum from the Dean recommending the action
  • a memorandum from the department Chair, if applicable
  • a current vita (no more than three months old)

Areas that do not apply should be marked "N/A." When the appointment has been reviewed and approved, a copy of the form with the Provost's signature will be returned to the Dean's Office as official administrative approval.

Please Note: Follow the above link to the online version of the form. Click on the save icon on the toolbar to download the form to your computer. Use Adobe Acrobat to open, complete, and save the form so you can go back to it. Print the completed form and obtain appropriate signatures on the printed copy. Forward the signed copy of the form, with relevant supporting materials, to the Office of the Provost.

Check the appropriate box: Emeritus Appointment and/or Extension of Service.

Following is a list of the elements that must be completed:

1) Name
Use the format last, first, middle initial.

2) University Identification Number
List the faculty UID number.

3) Effective Date
Effective date of the proposed action (not the date on which the form is filled out).

4) School/Department
List the faculty member's current school and department. Commonly used acronyms are acceptable.

5) Rank/Title
Indicate the proposed rank/title, which would be EMASTP, EMASCP, or EMPROF for Emeritus appointments, as appropriate. For an Emeritus Appointment recommendation, the rest of the form is not applicable. For an Extension of Service request, indicate:

6) School/Department
List where the service requested is to be performed.

7) Rank/Title
Indicate the proposed rank/title, as appropriate for the proposed duties. In most instances, this will be the same rank the faculty member had at the time of retirement.

8) Appointment Period
Indicate month/day/year of effective date and end date. Please note, extensions of service are approved for a maximum period of one year at a time. Please submit Extension of Service forms for each reappointment.

9) Percent Time
Indicate percent full-time equivalency.

10) Assignment Duration
Choose from the following:

  • one semester of employment (regardless of whether Spring or Fall) = 4.5
  • standard academic year teaching appointment = 9.0
  • research appointment (regardless of the actual number of months) = 12.0

11) Full-Time Faculty
Indicate the full-time, academic year base rate, even if the faculty member is hired for less than a full year.

12) Part-Time Faculty
Indicate the rate of payment. This may be an amount per course, per semester, per hour, per student, or some other rate; please specify. For part-time faculty list the total salary that the faculty member is expected to receive and list the source of the funding (unit and department and source number, if applicable).

13) Teaching Duties
List by year/semester, course title and number, credit hours and estimated enrollments in the space provided.

14) Other Duties
List all other expected duties, such as research expectations, clinical/practicum supervision, etc.

15) Signatures
The department Chair and Dean should sign and date the form. When signed by the Provost, a signed copy of the form will be returned and will serve as official administrative approval.