Human Resources Division
Application for Academic Promotion
Deadline for receipt by Human Resources is 7 May 2015
Printing documents single sided is preferred. Please do not staple documents.
Details of Applicant
Employee Name
Department
School/Division
Current Salary Grade
(e.g. LL06, SL02)
Appointment Status
(tick one)
EFT
(% of employment)
 Fixed term
 Confirmation Path
 Permanent
 Confirmed Appointment
I am applying for promotion under the following
schedule of the Academic Staff Promotion Policy:
Standard being claimed in relation to promotion criteria:
Teaching
 C - Competence
 SC – Sustained Competence
 SHC – Sustained High Competence
 SOC – Sustained Outstanding Competence
 SOLC – Sustained Outstanding Leadership & Sustained Outstanding Competence
Research
 C - Competence
 SC – Sustained Competence
 SHC – Sustained High Competence
 SOC – Sustained Outstanding Competence
 SOLC – Sustained Outstanding Leadership & Sustained Outstanding Competence
Service
 C - Competence
 SC – Sustained Competence
 SHC – Sustained High Competence
 SOC – Sustained Outstanding Competence
 SOLC – Sustained Outstanding Leadership & Sustained Outstanding Competence
Documentation attached in this order
Tick
The staff member’s written personal statement (limit 3 pages, 1.5 spacing, 12 font)

Otago Teaching Profile which includes:

Self-Evaluation Statement (limit 2 pages, 1.5 spacing, 12 font)

Supporting Documents of:







a. Schedule of teaching responsibilities
b. Evaluations of Teaching: summary data forms and team leader data
c. Course Evaluations (optional)
d. Teaching Context forms (optional)
e. Peer review of teaching form (only if peer review used)
f.
Peer review of supervision
g. List of documents on-call (please note on your list who will be holding these
documents from May to November and a contact phone number for this person)

Copies of evaluative reviews in the case of staff members who have published a book or
evaluation reviews of artistic performances (if available)

Referees Form for staff seeking promotion to Associate Professor, Research Associate
Professor, Clinical Associate Professor, Professor, Research Professor or Clinical
Professor

Curriculum vitae in standard format

Evidence of acceptance of Publications (see notes on Curriculum Vitae - appendix 4
below)
The HOD/Dean’s confidential Assessment Statement (in standard format)
NO OTHER DOCUMENTATION MAY BE PROVIDED
Please identify any absences of three months or more since your last promotion or since your
appointment if you are applying for promotion to Associate Professor or Professor because of illness
or other reasons. Please do not provide any details of the illness. Your Head of Department will
confirm the absence:
Start
Date:
____/____/_____
End Date:
____/____/_____
Total No of
weeks:
Please identify any absences since your appointment because of parental leave:
Start
Date:
____/____/_____
End Date:
____/____/_____
Total No of
weeks:
Please identify any periods of three months or more since your last promotion or since your
appointment if you are applying for promotion to Associate Professor or Professor when your hours
were reduced significantly:
Start
Date:
____/____/_____
End
Date:
____/____/_____
Normal
FTE:
Reduced
FTE:
You may wish to comment on prolonged absences or changes of hours in your personal
statement.
Have you asked a second senior colleague to act in the role of completing the
Assessment Statement in addition to that of your HOD for this application?
(If so, the statement should submitted on or before the due date)


Yes
No
If YES, please name the colleague
Applicant signature
Date
____/____/_____
Please note:
Applicants for Associate Professor and Professor must submit separate electronic copies of their CV,
their personal statement and their list of referees to Human Resources Manager, Promotion and
Remuneration at email: academic.promotions@otago.ac.nz by the closing date of Thursday 7 May
2015.
Human Resources will acknowledge receipt of your application by email by 5pm, Tuesday 12
May 2015. Please provide your preferred email address below
Email address
Please ensure you pass this application onto your HOD by the date they require, BEFORE BEING
SENT TO HR by the closing date of 7 May 2015.
Key:
C
= Competence
SC
= Sustained Competence
SHC
= Sustained High Competence
SOC
= Sustained Outstanding Competence
SOLC = Sustained Outstanding Leadership and Sustained Outstanding Competence
Applicants for promotion under Schedule 1 (Additional salary increments/ He āpitihanga utu ā-tau) do
not need to claim a performance standard.