ACADEMIC DEVELOPMENT PROGRAM
2016 TEMPLATE
Round 1 for applications to undertake an ADP in the first half of 2017 only
Please note: this is a Word document, which will expand as you type in the information
1. PERSONAL DETAILS
Title:
First name:
Surname:
Staff ID:
Position held:
Academic level:
School / Institute / Unit:
Date of appointment to this University:
Full time / Fractional appointment:
Qualifications (educational/professional) you have obtained to date:
Equity considerations – Applicants are invited to provide a brief personal statement on any
relevant personal considerations that may have had an impact on their career trajectory that
will facilitate an assessment of their achievements relative to opportunity which is relevant to
their application. Relevant personal circumstances or arrangements can include: family
responsibilities, a temporary or permanent disability, relevant cultural expectations or
circumstances, periods of part time work and absences due to ill-health or injury. (1/2 – 3/4
page max):
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* Have you undertaken a Health and Safety Risk Assessment of your proposed program as
indicated in Clause 12 of the ADP Policy?
Yes / No
* Do you have a current, signed Workload Agreement?
Yes / No
* If your application involves the completion of a PhD or Doctorate, please provide details of
any provision in your Workload Agreement for this work:
* Have you participated in the Academic Performance Planning and Review Process?
Yes /
No
* Does your application include work on ongoing research grant projects
Yes / No
* If Yes: Please outline the nature of the work to be undertaken, details of the funding body
and award, and details of the funds that will be utilised from the research grant. (see Clause
13 of the ADP Procedures):
2. DETAILS OF LAST ADP (only to be completed if you have undertaken a previous
ADP/PDP/PEP/Academic Study Leave program)
Dates of last ADP (or equivalent)
From:
/
/
To:
/
/
What were the objectives of your last ADP?
List specific academic contributions and outcomes arising from your last ADP.
Please attach electronically the report for your previous ADP.
3. ADP DETAILS
This period of ADP would be spent: (tick as appropriate)
In Australia
Overseas
List name(s) of country(s) and dates:
Both
List name(s) of country(s) and dates:
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4. PROGRAM DETAILS
Proposed period of absence (maximum 22 weeks) with impact on only one teaching period:
22 week block period
2 x 11 week block periods (to be taken over a 2-year period)
3 x 7 week block periods (to be taken over a 2-year period)
From
___________________
Date
To _______________________
Date
Employees must take any annual leave accrued during the period of ADP, either during or
immediately upon completion of the ADP. Employees may apply for four weeks annual leave
or long service before, during or after an ADP. (See ADP Procedures)
Annual Leave
From:
To:
Long Service Leave
From:
To:
Leave without Pay
From:
To:
(except in circumstances such as family/carers' responsibilities, maternity or
illness/disability).
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Please note: the Committee suggests a limit of 5 pages for items 5 – 7 inclusive. You
may delete words provided for your guidance (those in italics).
The ADP Committee will ask itself:

Is the program clearly explained, without excessive detail, and feasible in the
time available, given the applicant’s background and earlier achievements?

Will there be clear outcomes or impacts to show that the program was
successful?

Are there clear benefits to both the applicant and the University?

Does the program involve working with colleagues at other institutions or
organisations, either overseas or within Australia? How will these
collaborations benefit the applicant and University in the longer term?
5. Your program objectives (ie what are you going to do?)
You must clearly outline how your program is aligned with the strategic plan of the
University and ; the goals and strategies of the School/Institute/Division.
If you are applying for an ADP to complete a research higher degree, please include
here a response to the criteria outlined in the ADP Procedures If the ADP is to be
undertaken to complete a research higher degree, the supervisor must certify that
completion is achievable by the end of the ADP period and certification must be
electronically attached to the ADP application.
6. How and where are you going to do it, and with whom?
You must clearly outline your justification as to why you have selected the
place/project/participants/outcomes for your proposed program.
7. What are the specific outcomes and outputs of what you plan to achieve and how
will they benefit both yourself and the University.
Note: Proposals will be assessed in terms of the mutual benefit to the University and
community and to the academic and/ or professional development of the applicant.
You must clearly demonstrate how outcomes/outputs will be achieved.
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8.
ITINERARY: This should be as detailed as possible. Please attach electronically
confirmation of your arrangements from the institution(s) / organisation(s) named.
Location - Name of
Organisation/Institution
9.
Period of
Attachment
Activities to be Undertaken while on
Attachment
ESTIMATES
Note: The limits of financial assistance from the University are shown in the ADP Procedures.
A.
TOTAL COSTS OF ADP PROGRAM
(Please include full details and estimated costs under each heading below)
Travel:
$
Accommodation:
$
Fees:
$
Dependants (if applicable): and see below
$
Other:
$
TOTAL
$
Amount of financial assistance sought from the University
$
Amount of financial assistance sought from research funds
$
Cost Centre:
Project Code:
Delegation holder:
If claiming any dependants, please list names and include the ages of children as at 1
Jan 2017
The financial assistance grant is awarded with the expectation that no further funds will be
sought from the School, Research Institute or other University unit for the duration of the
ADP. Requests for additional funding in exceptional circumstances must be submitted in
writing to the relevant Dean or Director providing full details of where funds are available to
draw on. Failure to notify the Dean or Director will normally result in the repayment of any
finanicial assistance grant.
I have read the ADP Policy and Procedures and understand the obligations imposed by the
Policy and Procedures should my application be successful.
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Please forward your application in electronic word format, along with your
abbreviated CV to adp@westernsydney.edu.au by the advertised closing date, with a
copy to your Dean / Director.
Do not send any hard copy attachments – applications will be evaluated solely on the
basis of the information contained in this electronic application, the Dean /Director
Report (which will be sought by the Office of People and Culture) and your response
(if applicable).
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CHECKLIST
ACADEMIC DEVELOPMENT PROGRAM
Have you:
1.
read the Academic Development Program (ADP) Policy and Procedures?
2.
checked the closing date for applications?
3.
confirmed your eligibility to apply (contact the ADP Coordinator
adp@westernsydney.edu.au)?
4.
completed the Academic Development Program application template?
5.
discussed your proposed program with your Dean/Director and other colleagues as
appropriate, including proposed timing, alignment with University/School/Institute
goals and strategies?
6.
electronically attached the report from your previous ADP (if applicable)?
7.
electronically attached documentation confirming arrangements for attendance at
other institutions / organisations?
8.
electronically attached an abbreviated curriculum vitae?
9.
provided confirmation of prior service (if applicable)?
10.
if you are applying for ADP to complete a research higher degree, have you attached
electronically certification from your degree supervisor that you would be expected to
complete the degree by the end of the proposed period of ADP?
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