FACULTY PROSPECT DATA FORM

advertisement
For Office Use only:
College _________
Tier ____________
FACULTY PROSPECT DATA FORM
PERSONAL INFORMATION
First Name
M.I.
Last Name
Street Address
Telephone
Email
Alt. Telephone
Alt. Email
EDUCATIONAL INFORMATION
Doctoral Phase:
MFA Phase:
PhD Complete |
PhD Complete |
ABD |
ABD |
6th yr |
6th yr |
Expected PhD/MFA Completion Date:
5th yr |
5th yr |
4th yr |
4th yr |
3rd yr |
3rd yr |
2nd yr |
2nd yr |
1st yr
1st yr
Major/Discipline:
PhD/MFA University:
Research/Dissertation Topic:
Academic Specialty/Interest Areas:
Degrees (Please list all degrees obtained or pending, including the university):
Teaching Experience:
Teaching Assist. |
Working on Postdoc?
Yes |
No
Recitation |
Lab Assist. |
Lecturer |
Adjunct |
Tenure Track
University Name:
Area of Research:
Date of Completion:
RIT INFORMATION
RIT is in compliance with the Immigration Reform and Control Act of 1986.
Legally able to work in the US?
Willing to relocate to Rochester?
Yes |
Yes |
No
No
Eligibility Comments:
Interested in learning more about RIT?
Interested in learning more about the Future Faculty Career Exploration Program?
Yes |
Yes |
No
No
How did you hear about us?
Office of Faculty Recruitment and Retention
Last Updated: 10/2011
TEACHING INFORMATION
Courses Competent to Teach:
Academic Areas Interested in Teaching/Developing in the Future:
Research Areas:
Interested in teaching at RIT?
Interested in Postdoc?
Yes |
Yes |
No
No
Interested in administrative positions?
Interested in international teaching positions?
Years of Industrial Experience:
Data available to being a faculty position:
Yes |
No
/
Yes |
Curriculum Vitae attached?
/
No
Yes |
No
Comments:
Scholar Type:
DEMOGRAPHIC INFORMATION
RIT values diversity within its workforce and therefore would appreciate your completion of the information listed below.
Your submission of this information is optional. This data is for analysis and affirmative action reporting only.
Gender:
Male |
Race/Ethnic Group:
Female
Vietnam Veteran:
White |
Hispanic/Latino |
Yes |
No
Disabled Individual:
American Indian/Alaskan Native |
Native Hawaiian/Pacific Islander |
African American |
Signature: ______________________________________
Yes |
No
Asian
No Response
Date: ______________________
Office of Faculty Recruitment and Retention
Rochester Institute of Technology
90 Lomb Memorial Drive
Rochester, New York 14623
(585) 475-2686
[email protected]
Office of Faculty Recruitment and Retention
Last Updated: 10/2011
Download