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 subject to the Professional Development Plan (PDP) process may apply by submitting this application
form, a current PDP, a current Vita/Résumé, and any other documents they consider relevant. Applications may be done
concurrently with the PDP reviews.
Faculty not subject to the PDP process must attach a current résumé and brief document outlining their
achievements related to the five eligibility/appointment criteria found in Section C, II, 1, b-e.
Renewal members must attach an updated résumé and achievements related to the five eligibility/appointment
criteria as found in Section C, II, 1, b-e.
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
__________________________________________ Date______________ Approved_____ Disapproved____
Director, School of Graduate Studies
__________________________________________ 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.
August 2013