Form EP/Nom 15/16 King’s College, London External Peer for Programme Approval and Review Nomination Form Please complete this form in capital letters and submit to the Quality and Academic Support Office, King’s College London, James Clerk Maxwell Building, 57 Waterloo Road, SE1 8WA. Part A: Personal Details Title Forename(s) Surname Position Home Institution Address of institution (including Department) Phone number Email address Please tick box if you would like forms to be sent to you in electronic format Correspondence address (if different from above) 2015/16 Form EP/Nom 15/16 Eligibility to work in the UK As you may be aware, the UK Border Agency requires that all of those undertaking work in the UK have the legal right to do so. In order to undertake the above work you must verify your eligibility to work in the UK and you are asked to complete the self assessment process set out below and attach any supporting documentation that may be required. The appointment as an external examiner is subject to this selfdeclaration being completed and the provision and verification of appropriate copy documentation being forwarded, where required, to the Quality and Academic Support office. Please indicate which statement below applies to you by placing a tick in the appropriate box and inserting the name of your current university as may be appropriate. 1 I am both a British Citizen (United Kingdom passport holder) and an employee of a British university or institution. Specify university or institution: ...................................................................... 2 I am a holder of a passport from a nation of the European Economic Area or Switzerland. http://www.ukba.homeoffice.gov.uk/eucitizens/ Specify university or institution: ...................................................................... 3 I do not hold a UK Citizen or European Economic Area/Switzerland passport, but I am an employee of a British university or institution and have indefinite leave to remain in the UK. Specify university or institution: ........................................................................ 4 I am a non European migrant and have a visa which allows me to undertake work in the UK. 5 I have a Tier 2 visa and this work meets the UKBA “Supplementary employment criteria” as follows: The King’s College London work is work in the same sector and at the same professional level as the work for which my Certificate of Sponsorship was assigned; and The time taken for this and supplementary employment I undertake for any other employer is no more than 20 hours per week; and Is undertaken outside of the normal working hours for which my certificate of Sponsorship was assigned. Specify university: ............................................................................... 6 None of the above applies. 2015/16 Form EP/Nom 15/16 If you have ticked statement 3, 4 or 5 you need to attach a copy of the front cover and photo page of your passport and evidence of your right to work in the UK to this document. If you have ticked statement 6 we will need more information in order to determine whether you can undertake this work. Please could you attach a copy of the front cover and photo page of your passport and any and documentation that will allow us to determine if you are able to undertake this work. Part B: Experience External peers should meet three or more of the following criteria. Please indicate which are applicable, providing details as appropriate. Please Please provide details as tick is appropriate applicable Experience of either the role of Head of Department/Faculty/ School or programme director and/or chairmanship of an institutional level committee concerned with teaching and learning or other senior role Wide experience as a External Examiner Familiarity with research-led teaching Familiarity with national quality assurance policies Knowledge of and experience of using subject benchmark statements Previous experience as a QAA subject reviewer, review chair or institutional auditor and/or experience of being a subject contact for a QAA subject review 2015/16 Form EP/Nom 15/16 Please complete the boxes with Y (yes) or N (no) as appropriate Have you been employed by King’s College London in any capacity in the last three years? If yes please provide details of your appointment with the dates; any teaching duties should be mentioned Have you been a governor, student, external peer or external examiner of King’s College within the last three years? If yes please provide details with dates To your knowledge, is there a member of staff of King’s College London appointed by your institution in the capacity of External Peer in the same subject area in which you are nominated to serve at King’s? If yes, please state the name of the External Peer and the subject Part C: Declaration To the best of my knowledge, the particulars given by me on this form are correct. Signed Date 2015/16 Form EP/Nom 15/16 Part D: For King’s College use only Approved by Executive Dean of Faculty (Institute/School) Signed Print name Date Approved by Chair, College Education Committee Signed Print name Date Part E: For QAS Section use only Name of Faculty Education Committee Academic session Date completed form received Date of CEC approval Further action/comments: 2015/16 Date of commencement of appointment Date appointment letter sent Date information pack sent