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