University of South Florida
College of Public Health
Application for Tenure Upon Appointment
INTRODUCTION
This form contains information requested by the College of Public Health to be used in considering requests for
tenure upon appointment. Please forward the completed form, along with an updated CV, to the Associate Dean for
Faculty Affairs, Paula Knaus at pknaus@health.usf.edu.
Applicants are encouraged to review the College of Public Health Appointment, Promotion and Tenure Guidelines for
examples of activities to be included in this document. The APT Guidelines can be found at
http://health.usf.edu/publichealth/facultyaffairs.edu
Note: If the information for a specific question is documented in your CV, it is not necessary to list it in the form. Just
indicate on the form the specific page number(s) where the information can be found in your CV.
APPLICANT INFORMATION
Name: ___________________________________________
Degree (s): _________________________
Current Rank: _________________________________
Tenure: Yes ___ No ___
(check one)
Current University: _____________________________________
Effective Date: _______
Current College: _______________________________________
Mail Address:
_______________________________________________________________________________________
E-mail Address: ________________________________
Telephone Number: __________________
I am seeking appointment to the rank of ________________________ with tenure upon appointment.
__________________________________________
Applicant’s Signature
____________
Date
1
Tenure Upon Appointment Application
Applicant Name
Date
1.
AREAS OF SPECIALIZATION IN RESEARCH/CREATIVE ACTIVITY:
2.
HONORS, AWARDS, ETC.:
3.
ASSIGNED DUTIES OF CANDIDATE : (Please estimate the percent of your total effort that was assigned
per year during the past five years in the broad areas of teaching, research/scholarship and service.)
4.
TEACHING:
A.
GOALS & ACCOMPLISHMENTS: (Provide a concise narrative describing your
goals and accomplishments in the area of teaching. Address components of teaching found in the COPH APT
Guidelines.)
B.
COURSES TAUGHT: In order to provide reviewers with an overview of the variety of courses you have
taught, please list all courses you have taught, but list each only one time.
C.
TEACHING AWARDS, DISTINCTIONS: (List all awards, distinctions, etc. and year received.)
(1)
Teaching Awards and Other Recognition:
(2)
Textbooks Published:
(3)
New Courses Developed:
(4)
Scholarly Papers Published on Teaching in Your Field (items entered here should not also be listed in
the research section):
(5)
Innovative Methods (please describe how this method is innovative in your field):
2
COPH Tenure Upon Appointment Application
Applicant Name
Date
D.
DOCTORAL DISSERTATION COMMITTEES: (Please list numbers and your role.)
Note: Please indicate if there is not a Ph.D. Program in your department.
E.
MASTER'S THESIS/MAJOR PAPER COMMITTEES: (Please list numbers and your role.)
F.
STUDENT EVALUATION OF TEACHING: (Please provide any relevant data available to answer this
section.)
5.
RESEARCH AND CREATIVE ACTIVITY:
A.
GOALS & ACCOMPLISHMENTS: (Provide a concise narrative describing your
goals and accomplishments in the area of research and creative activity.)
B.
PUBLICATIONS: (Provide lists in your discipline’s reference style format; if multiple authors,
list authors in order they appear in the publication.) Items should be entered in only one place in
the application. If you enter an item in one section, do not enter it again in another section
(including the section on Teaching.)
(1)
Books
(2) Textbooks
(3) Chapters or Segments of Books
(4) Refereed Articles (List, beginning with the most recent. Be certain to underline your name for all
articles for which you are senior author)
(a) Refereed Articles Published:
(b) Refereed Articles Accepted for Publication (attach copy of the letter of acceptance from publisher):
(c) Refereed Articles Submitted for Review (attach a copy of your letter of transmittal to publisher):
(5) Non-Refereed Articles (List, beginning with the most recent. Be certain to underline your name for
those articles for which you are senior author).
3
COPH Tenure Upon Appointment Application
Applicant Name
Date
(6) Technical Reports
(7) Other Research and Creative Activities (List, beginning with the most recent. Be certain to
underline your name for those activities for which you were senior author or lead member):
Patents and Licensing:
C. GRANTS AND CONTRACTS
(1) List grants and contracts, including training grants, that you have participated in as principal investigator
director, co-principal investigator, and/or other significant role (e.g., Co-Investigator, Evaluator, other
major role) during the last five years. Begin with the most recent and include:
-
principal investigator, director, and all co-principal investigators on grants & contracts; if multiple
investigators, specify the relative contribution you made to the grant/contract
title
agency
purpose of research or training
total amount funded
candidate’s share of amount funded
dates to start and end
(2) List grants that are currently under review. Begin with the most recent:
D. PRESENTATION OF PAPERS / MAJOR SPEECHES:
(List, beginning with the most recent, in each category. Indicate in each listing if you were “invited” to
present or speak. Be certain to underline your name for those papers or presentations for which you
are senior author or lead member).
(1) Papers Presented at Professional Conventions (Please indicate if refereed)
-
International
-
National
-
Regional
-
Local
4
COPH Tenure Upon Appointment Application
Applicant Name
Date
6.
SERVICE:
A.
GOALS & ACCOMPLISHMENTS: (Provide a concise narrative describing your
goals and accomplishments in all areas of service.)
B.
SERVICE TO THE UNIVERSITY if relevant:
C.
SERVICE TO YOUR PROFESSION:
D.
SERVICE TO THE COMMUNITY: List community committee councils, boards, etc., on which
you have served or other public service activities. Include dates of service.
7.
EXTERNAL REVIEWS OF RESEARCH AND CREATIVE ACTIVITY: Attach 5 letters from
external reviewers.
March 10, 2015
5