HUIIIAI{ RESOURCE SERVICES
urriverslty
of Northern
UTTKb
lowa
Request for Faculty Emeritus Status
i,tame John
I
T.
Fecik
Department
Industrial
Technoloqy
wish to retire from my position as
at the University of Northern lowa,
effective June 30, 2011
have twenty (20) or more years of credible service in higher education (Lisl institutions and dates of employment)
Unlverslty of Northern Io\na
lnslilution
Cheyney
Un i
versi
ty of
Pennsylvania
lnstitulion
University of Maryland
lnstitulion
August, 1981 to June,
2011
Date
Septenber, 1970 to Ausust, 198I
Date
SeDtenber. 1965
to Ausust.
1970
Date
Oahlo' torzotl
Date
Co ege Chair Senete: lnclude a statement verifying that ten ( 10) years of meritorious service has been concluded with
the University of Northern lowa. (L,se the back of this form if more space is reqlired.)
.
a
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College Senate Chair
-v
rlf o2l //
Date
(e^ t\^\L
Dale
tzl5/ u
Dean of College (if applic€ble)
Date
University Faculty Senate Chair
Date
Provost and Vice President
Date
Date
P|ease prcparc thls lorm: sign and subnt to your depattment head. When the process for approval has boen conpleted, the division
head s olfrce will make copies and clisttibute th6m to each ol the above signatories and the Deparlnent ot Hunan Resource Services
02/G chrisl
.
CedffFalls A5A614-QQ31. P 31927X2422. F:3192732927' h6benelils@un.edu. http:// \l'r.uni€du/hE/
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