Nottingham Recognition Scheme
CLAIM FORM
Complete this form, and submit it to the TLD with your evidence document (Written
Submission or Presentation Plan) and your References to make your claim for recognition and
to begin the reviewing and decision-making processes.
Your Head of School or School Director of Teaching should be made aware that you are
claiming recognition.
Name: ___________________________________________________________
School: ___________________________________________________________
Recognition claimed:
(delete as appropriate)
Associate Fellow (D1)
Submission mode:
(delete as appropriate)
Written Submission
/
/
Fellow (D2)
/
Senior Fellow (D3)
Submission by Presentation
I confirm that the following submission documents are included with this claim:
Either
[ ]
for Written Submission:
 Claim Form
 Written Submission
 References
Or
For Submission by Presentation:
 Claim Form
 Presentation Plan
 References
I confirm that my Head of School / School Director of Teaching and Learning is aware of
my claim for recognition.
Signed: _______________________________________________________________
Date: __________________________________________________________________
OFFICE USE ONLY
[ ] Submission complete
www.nottingham.ac.uk/tld/nrs
T&L Directorate, April 2015