University of Wisconsin-La Crosse GRADUATE FACULTY STATUS APPLICATION (Please type or print. Submit vitae or resume with application.) Name of Applicant: Signature of Applicant: Department: Applying for: New College: Full Membership Associate Membership Affiliate Membership Adjunct Membership Emeritus Membership Professional Membership Provisional Membership (1 semester only) Change Renewal Appeal Applicant 1. On a separate sheet of paper, please describe your accomplishments which support your request to be appointed or reappointed to the Graduate Faculty. Be sure to include the following with your application: Current resume or vita Chair’s letter of support Department scholarship statement Department Level Review 1. Check the category approved at the department level on the next page. 2. The chair should provide a letter which addresses the applicant’s qualifications and competence to serve on the Graduate Faculty in accordance with the criteria outlined in the University Policies regarding Graduate Faculty. The chair’s letter should discuss the evidence in support of the faculty member’s appointment or reappointment to the Graduate Faculty at the requested category. 1 Revised 10-14-11 Please check the category approved at the department level. Individual departments can have more stringent requirements. CATEGORY ____ Full Membership ____ Associate Membership _____Affiliate/Adjunct Membership _____Emeritus Membership _____Professional Membership _____Provisional Membership CRITERIA Full members have the opportunity to engage in the following responsibilities: a) teach graduate courses; b) serve as program director; c) direct/supervise graduate fieldwork experiences: practicum, internships, preceptorships; d) direct/supervise culminating projects: applied/independent studies, seminar papers/presentations, theses, comprehensive examinations; e) serve as chair, co-chair or member: thesis, comprehensive examination, research/specialist project, case conceptualization; f) serve as member of Graduate Council and/or Graduate Curriculum Committee. Membership will be granted indefinitely for UW-L staff and faculty. Associate members have the opportunity to engage in the following responsibilities: a) teach graduate courses; ; b) serve as program director; c) direct/supervise graduate fieldwork experiences: practicum, internships, preceptorships; d) direct/supervise culminating projects: applied/independent studies, seminar papers/presentations, theses, comprehensive examinations; e) serve as co-chair or member: thesis, comprehensive examination, research/specialist project, case conceptualization; f) serve as member of Graduate Council and/or Graduate Curriculum Committee. Membership will be granted indefinitely for UW-L staff /faculty. Affiliate/Adjunct members have the opportunity to engage in the following responsibilities: a) teach graduate courses; ; b) direct/supervise graduate fieldwork experiences: practicum, internships, preceptorships; c) direct/supervise culminating projects: applied/independent studies, seminar papers/presentations, theses, comprehensive examinations; d) serve as member: thesis, comprehensive examination, research/specialist project, case conceptualization. Membership may be granted for a period of up to 5 years with annual confirmation by department and is renewable. All memberships will end in August. Emeritus members have the opportunity to engage in the following responsibilities: a) teach graduate courses as approved by department; ; b) direct/supervise graduate fieldwork experiences: practicum, internships, preceptorships; c) direct/supervise culminating projects: applied/independent studies, seminar papers/presentations, theses, comprehensive examinations; d) serve as chair, co-chair or member: thesis, comprehensive examination, research/specialist project, case conceptualization. Membership may be granted for a period of up to 5 years with annual confirmation by department and is renewable. All memberships will end in August. Professional members have the opportunity to engage in the following responsibilities: a) teach graduate courses; ; b) direct/supervise graduate fieldwork experiences: practicum, internships, preceptorships. Membership may be granted for a period of up to 5 years with annual confirmation by department and is renewable. All memberships will end in August. Provisional membership may be granted when a compelling need warrants. A request for provisional membership should be initiated by the department chair and approved by the appropriate dean before being submitted to the Office of Graduate Studies. Responsibilities and duties for Provisional membership include any listed 2 Revised 10-14-11 in Appendix A of the Graduate Faculty Membership document and must be approved by the department chair, dean of the corresponding college and the Graduate Council. Provisional membership may be granted for one semester (fall or spring) with the inclusion of a contiguous summer session. In exceptional circumstances, provisional membership may be extended for one more semester. Faculty anticipating extended need for Graduate Faculty Membership must apply for one of the above categories. Dean’s Level Review: Please check to make sure the required supporting evidence is included with this application. Current Resume or Curriculum Vitae (CV). Chair’s Letter ........................................................................................... Department Scholarship Statement Complete Application Recommendation from Department Chair Chair’s Signature: ______________________________ Date________________ I support the membership category requested. Yes No Rationale (Additional Comments): I support this category instead: ___Full ___Associate ___Affiliate _____Adjunct ____ Emeritus ____ Professional ___Provisional Recommendation from the Dean Dean’s Signature: ______________________________ Date________________ I support the membership category requested. Yes No Rationale (Additional Comments): 3 Revised 10-14-11 I support this category instead: ___Full ___Associate ___Affiliate ____ Adjunct ___ Emeritus ___ Professional ___Provisional Decision of the Graduate Council Council Chair Signature: _________________________ Date________________ The Council supports the membership category requested. Yes No Rationale (Additional Comments): The Council supports this category instead: ___Full ___Associate ___Affiliate ____ Adjunct ___ Emeritus ___ Professional ___Provisional 4 Revised 10-14-11