Standard Application Academic Promotion Level B * Application must be double-sided. Section 1: Application Form Personal Details Title Surname First Name E-mail Address Correspondence Address Appointment Details Position Title Current Academic Level School/Directorate Portfolio Campus Date of Initial Appointment Date of Appointment/Promotion to Current Academic Level Continuing or Fixed-term Appointment (include expiry date) Current Fraction Length of Service at the University Have you successfully completed your probationary period? Levels of Achievement Claimed Refer to Academic Promotion Procedure for Level B Sustained Contribution Meritorious Outstanding Distinguished Learning and Teaching Research and Creativity Leadership and Engagement CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 1 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Additional APPLICANT Information Yes No Does your promotion application include a case of achievement relative to opportunity? Does your promotion application include approval of equivalent accreditation and standing status? Please print name Signature Date Contact Extension No. * Privacy Collection statement Information on this form is collected for the primary purpose of assessing an application for academic promotion; communicating with the applicant; attending to administrative matters; de-identified statistical analysis; and disclosure to the promotions committee. By signing this application, you consent to the information contained in it to be disclosed and used as described. CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 2 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 2: Case for Promotion Section 2.1: Summary Statement of Key Achievements This should be a case for promotion argued according to the criteria for the level of promotion being sought. It should be written as a succinct overview statement highlighting key achievements. Note that Section 4, Professional Folios, provides the opportunity to discuss in detail and to cite evidence in support of these achievements, and to provide critical reflection. Maximum word length is 1,500 words. Word Count: Section 2.2: Discipline Context Summary (Maximum word length is 250 words) Provide a context summary of your discipline/research area (e.g. opportunities and challenges). Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 3 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 2.3: Case for Achievement Relative to Opportunity (Maximum word length is 800 words) Applicants may outline work arrangements and special circumstances, and their impact on career progression and performance. Please refer to Academic Promotion Policy. Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 4 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 3: Curriculum Vitae This template is provided to assist applicants and provides a preferred format, however you may adjust or add to the sub-headings and extend spaces provided for information. Your curriculum vitae should not exceed three pages in length. Academic Qualifications Formal Qualifications Year Qualification University Other Qualifications Year Qualification Institution Further Study being Undertaken Expected completion date: Confirmation of satisfactory progress by Supervisor Signature of Supervisor Date Appointments Current Appointment Year Position Location Position Organisation Previous Appointments Year CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 5 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Academic/Professional Awards and Distinctions Academic/Professional Association Memberships/Roles CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 6 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 4: Professional Folio Introduction: The Professional Folio is a structured format for presentation of supporting evidence in the three areas of achievement and a commentary on the quality and impact of achievements. Original documents and records must be submitted to Human Resources preferably in an electronic format. Templates provided are to assist preparation of supporting evidence and represent the preferred format; however applicants may adjust or add to sub-headings as required and within the advised word limit. CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 7 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 4.1: Professional Folio – Learning and Teaching Summary of Major Learning and Teaching Responsibilities and Initiatives (up to 500 words) Word Count: Learning and Teaching Quality and Impact Indicators (Verifiable Outcomes) List any significant outcomes of your work (this may include external awards, publications, invited presentations or internal influence and impact on curriculum, assessment etc.). Year Teaching Quality and Impact Indicators Learning and Teaching Collaborations Year Formal Teaching Contact List most recent first. Year/ Semester Course Code/ Name Credit Points % Contribution to Unit (not including preparation time) Other Data (include class sizes, mode of teaching, role – course/program developer, course/program coordinator, lecturer, tutor) Research Supervision of HDR/Honours students Student Name Type of Degree # Current Student (Y/N) Completed Student (Y/N) Years Role ## # PhD, professional doctorate, masters by research, honours ## Principal Supervisor [PS], Associate Supervisor [AS] CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 8 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Supervision of Masters by Coursework students Current Student (Y/N) Student Name Completed Student (Y/N) Years Role ## ## Principal Supervisor [PS], Associate Supervisor [AS] Clinical or Applied Supervision This may apply to clinical, industry or other applied settings for undergraduate and/or postgraduate students. Year/ Semester Course Code/Name Number of Students Supervised Activity (e.g. observation, assessment, liaison with industry supervisors, mentoring) Summary of Student Evaluations Year/ Semester Course Code/Name Number of Students Score/Evaluation Evaluation of Teaching (up to 500 words) Provide comments on your feedback, elaborating on any specific actions taken in response to feedback. Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 9 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Critical and reflective commentary on activity and achievement in Learning and Teaching (up to 1,000 words) This section provides an opportunity to discuss activity and achievement against the criteria for promotion. Include, for example, recent reading in learning and teaching, a discussion on how research informs your teaching, discussion of evaluative feedback from peers and students. Identify significant activity in areas such as innovative teaching practices, curriculum development, assessment, development of flexible/blended delivery courses, response to student feedback and effectiveness in promoting student learning. Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 10 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 4.2: Professional Folio - Research and Creativity Major Research Themes (up to 500 words) Word Count: Research Quality and Impact Measures (Verifiable Outcomes) List significant outcomes of your work Year Research Collaborations Year Further Information on Creative Arts Research (up to 800 words) For staff undertaking research in the Creative Arts you may make a further statement to allow you to adequately express your case including exhibitions/performances and refereed/reviewed competitions/exhibitions/performances. Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 11 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Funding Year(s) Brief Title of Grant/Project Success Y/N or Pending Funding Body Chief Investigators and Other Staff Members Individual Total Value of Contribution Grant ($) (%) ** ** If applicable Citation Factors Bibliographic Record Refereed Journal Articles Books Chapters in Books Refereed Conference Papers ** If applicable Non-Refereed Publications List all non-refereed publications - most recent first. % Contribution Publication Accepted/ In Press Top 5 Outputs No. Description of Research Output Title of Work (Publication, Performance, Exhibition) Year Individual Contribution (%)** DIISRTE Category** Citation Information** 1 2 3 4 5 ** If applicable CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 12 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Critical and reflective commentary on activity and achievement in Research and Creativity (up to 1,000 words) Elaborate on the scope, quality and impact of your activity and achievement. Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 13 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 4.3: Professional Folio – Leadership and Engagement Leadership within the School and the University This may include committee membership and activity, special projects, serving as a representative of the University on external bodies, liaison with industry representatives, and service to professional associations or discipline related groups. Dates Description of Role Engagement Activity This may include professional service, practice based research, project leadership with community partners, problem solving, policy development, change management, public education and advocacy funded projects, and entrepreneurial activity leading to outcomes for the discipline, School, University or community. Dates Description of Role Critical and reflective commentary on activity and achievement in Leadership and Engagement and where appropriate the integration of teaching, research and educational leadership (up to 1,000 words) Word Count: CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 14 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 5: Referees Applicants to Level B must nominate two referees (one of whom is external). Title Name Postal Address: Suburb/Town: E-mail Address State: Phone Number: Post Code: Fax Number: Why referee was chosen: Internal Referee Title External Referee Name Postal Address: Suburb/Town: International Referee E-mail Address State: Phone Number: Post Code: Fax Number: Why referee was chosen: Internal Referee CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources External Referee International Referee Page 15 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Section 6: Senior Discipline Leader’s Report To be completed by the Senior Discipline Leader or the applicant’s PRDP supervisor or nominee. Senior Discipline Leaders are asked to prepare a report that addresses the merits of the applicant’s case in the areas of Learning and Teaching, Research and Creativity and Leadership and Engagement with reference to the levels of achievement claimed by the applicant. This report must be typed. Senior Discipline Leader’s Details Title and Full Name School/Portfolio Position Held E-mail Address Correspondence Address Phone Extension Senior Discipline Leader’s Comments on Learning and Teaching Senior Discipline Leader’s Comments on Research and Creativity Senior Discipline Leader’s Comments on Leadership and Engagement Senior Discipline Leader’s Comments on Contribution to the Faculty and University’s Charter CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 16 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Senior Discipline Leader’s Comments on Case for Achievement Relative to Opportunity Any other information relevant to the application Senior Discipline Leader’s Recommendation The case presented by this applicant is (place an x on the scale below to indicate support): 5 0 Strongly Supported Not supported Provide reasons for your recommendation: Please print name Senior Discipline Leader’s Signature Date CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Contact Extension No. Page 17 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B APPLICANT is required to complete the following section I have read the contents of the Senior Discipline Leader report. Please print name Applicant’s Signature Date Contact Extension No. Applicant Response to the Senior Discipline Leader’s Report (optional) (Maximum word limit is 500 words) CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 18 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B TYPES OF SUPPORTING EVIDENCE FOR APPLICATIONS Example of types of supporting evidence are below. Supporting evidence must be submitted with your application and preferably in electronic format (e.g. memory stick). Learning and Teaching SET/SEC reports eVALUate reports Other forms of student evaluation Peer review/evaluation ALTC or OLT citations VC awards or faculty awards Learning and teaching reports Course Coordination activities Acknowledgement as a specialist lecturer Learning and teaching publications and conference presentations Invitations to present at Learning and Teaching conferences Program innovation Research and Creativity Records of supervision of undergraduate/honours students Research supervision/supervision of Masters by Research students Research implementation plan Journal articles/publications/chapters in books Invitations to referee journals Conference participation/presentations/publications Peer review citations Grant/funding applications Research reports Industry reports Invitations to editorial boards Referee comments Reviews about creative works CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 19 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B Leadership and Engagement Committee membership Coordination roles/other responsibilities within the School/Faculty Discipline administration Development of linkages with other Schools and Faculties Invitations to be on editorial boards Development of linkages with relevant community groups/networks Industry seminars/workshops and/or professional practice Membership of professional associations Partnership reports Consultancy reports Activities which raise the profile of the University Please note, these examples are not exhaustive. CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 20 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015 Standard Application Academic Promotion Level B CHECKLIST FOR SUBMITTING APPLICATIONS Have you: Checked your eligibility?: Completed at least one year’s service at date of call? Successfully completed probationary period? Participated in PRDP? Hold a master's level degree or PhD or equivalent accreditation and standing. Completed the application correctly and provided all required information?: Signed your applications in Section 1? Attached and provided your supporting evidence? (Preferably on a memory stick) Has the Senior Discipline Leader’s report been included with recommendation selected and signed? Have you acknowledged and signed that you have read the Senior Discipline Leader’s report? Are your referees correctly nominated?: 2 referees – at least 1 external referee*. * External referee must not have been employed by FedUni during the three years preceding application closing date. CRICOS Provider No. 00103D Warning: uncontrolled when printed. Authorised by: Director, Human Resources Document owner: Director, Human Resources Page 21 of 21 Original Issue: Current Version: 18/06/2013 01/09/2015