Bemidji State University
Graduate Faculty Membership Nomination
New Membership
Status: BSU Faculty:
Full
Retired/Emeriti BSU Faculty:
Community:
Full
Renewal
Associate (*Section C)
Associate (*Section D)
Associate Only (*Section E)
Temporary Graduate Faculty Status (*Section C) was granted on
*See membership criteria for complete explanation of differences
All information received will be confidential and used only for the purpose of making a determination relative to selection
for membership on the BSU Graduate Faculty. Faculty need to document they meet the criteria as outlined in the
membership criteria as related to graduate education. This could include a current Vita/Résumé, pertinent information
from your Professional Development Plan (PDP), or any other document(s) considered relevant.
Name:
Date:
On-Campus Address:
Off-Campus Address
For Non-BSU members only:
Address, City, State, and Zip Code
Position Title:
Telephone # (office):
Dept.
Years of Service at BSU:
Current E-mail Address:
Nomination by (self-nomination is acceptable):
Name_____________________________________ Date______________ Dept._______________________
By signing this form, I attest that departmental protocol was followed and that a two-thirds vote of the department or
program was secured.
__________________________________________ Date______________ Approved_____ Disapproved____
Department Chairperson
__________________________________________ Date______________ Approved_____ Disapproved____
College Dean
__________________________________________ Complete _______
Date to VP___________________
Director, School of Graduate Studies (checks for completeness of documentation)
__________________________________________ Date______________ Approved_____ Disapproved____
Vice President for Academic and Student Affairs
Graduate Students are required to have three (3) members from the Graduate Faculty to serve on their
graduate committees; this includes their advisor and two other members. To assist our students in securing
faculty to serve on these committees, please list at least three areas of interest. This list would be compiled and
placed on the School of Graduate Studies website for students to access. They could simply review the areas of
interest for each of the graduate faculty and if their topic is one listed, they could contact the faculty member
and ask if that individual would be interested in serving on their graduate committee. The selection of all
graduate faculty committee members is subject to advisor approval.
Your areas of interest are:
Please complete and forward to your Department Chair. Once signatures have been secured,
return to the School of Graduate Studies in Deputy 111.
December 2014