Recommendation for Part-Time Faculty Reappointment Form

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.

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

2) University Identification Number
List the faculty UID number.

3) Academic Year
Indicate the Academic Year during which this part-time reappointment will be in effect.

4) School-Department
List the academic unit and department name. Commonly used acronyms are acceptable.

5) Rank
Indicate current/proposed rank.

6) Percent Time
Indicate full-time equivalency as a percentage: less than 75% = part-time.

7) Reappointment Period
Use the format month/day/year for the start and end of the reappointment.

8) Rate
This may be an amount per course, per student, per hour, or some other rate of payment; please specify.

9) Total Salary
Indicate total amount the faculty member is expected to receive.

10) Funding Source
Indicate the unit/department budget to be charged, e.g. unit-department-object code-source. Include restricted funding sources if applicable.

In the following space, list the courses to be taught in the same format as indicated. If more space is needed, use the Continuation Form for History of Courses Taught (PDF) .

11) Appointment History
Provide the requested history, including:

  • initial appointment date
  • last reappointment date
  • last rate (amount per unit) of payment
  • last total salary
  • last rank
  • last % time

Also list the courses taught previously in the same format as indicated.

12) Chair's Evaluation
In the space allotted on the form, provide a brief statement from the Chair of the department which includes an evaluation of the faculty member's qualifications and other professional activities.

13) Dean's Evaluation
In the space allotted on the form, provide a brief statement from the Dean which includes a justification for the position.

14) Signatures
The Chair and Dean must sign and date the form. A signed copy will be returned as official administrative approval.