UCS PASSPoRT (Pathways for Academic and Support Staff to Professional Recognition of Teaching) Scheme
Application proforma for HEA Recognition via PASSPoRT CPD Pathway
D1
Associate Fellow
by Written Submission
Applicant Details
Name
Role
Faculty/ Department
Email
Phone
Applying for:
Associate Fellow
Please complete all sections of this application before sending it to the UCS PASSPoRT Manager:
 Part 1 Evidence Grid of Professional Activity (p. 2)
 Part 2 Demonstration of Professional and Developmental Activities in meeting at least two areas of
activity and relevant core knowledge and professional values in the Dimensions of Practice of the UK
PSF
 two completed References
and submit by email to christine.smith@ucs.ac.uk
Signature _________________________ Date __________________
Please refer to the PASSPoRT Handbook for Applicants for guidance on how to complete your submission.
We recommend you to integrate planning for your Associate Fellowship application into your annual
appraisal, discussing the different elements with your line manager as appropriate. It is important that you
also contact the PASSPoRT Manager, or a recognised Fellow of the HEA, ideally (but not limited to) in your
department, for support as a mentor prior to completing this submission. Alternatively, or in addition, we
recommend you participate in one of the relevant awareness-raising sessions or writing retreats organised by
the PASSPoRT Manager. Details of events and more PASSPoRT information can be found on the PASSPoRT
webpages at: http://www.ucs.ac.uk/passport
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UCS PASSPoRT (Pathways for Academic and Support Staff to Professional Recognition of Teaching) Scheme
Part 1:
Evidence Grid of Professional Activity
Examples of professional activity
Engagement with at least 2 areas of
activity and relevant core
knowledge and professional values
in the Dimensions of Practice
AA1-5
CK (1-6)
How does each example demonstrate evidence for,
and/or your engagement with, statements I-IV for
Descriptor D1 in the UK PSF
Dates/
Duration
PV (1-4)
Add more rows as required
Please complete this evidence grid to identify all relevant and recent examples of professional activity that support your statements in the written submission sections of this
document. For example, you might mention your role as a lecturer or your role in supporting student learning, attending a subject-related conference or perhaps a role you have
held in linked to teaching and learning within your Department or professional area. For each example, you are asked to indicate its alignment with one or more of the
Dimensions of Practice of the UK PSF and with the statements I-VI for Descriptor 1– see https://www.heacademy.ac.uk/professional-recognition/uk-professional-standardsframework-ukpsf Please also include any relevant dates to demonstrate the currency and/or extent of the activity examples.
Once you have completed this record of Professional Activity, you might draw upon some of the examples to reflect on the effectiveness of the activity and its impact on the
quality of student learning and/or the student experience within your area of practice. Use these examples to complete Part 2: ‘Demonstration of Professional and
Developmental Activities’ to demonstrate how you meet the criteria for Associate Fellowship of the HEA.
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Part 2:
Demonstration of Professional and Developmental Activities for D2 Fellow
a. Introduction:
A brief Introduction to your professional practice experience including your own learning and teaching
philosophy (200 words)
b. Meeting the Dimensions of Practice in the UK PSF
A critically reflective account of how your recent experiences, activities and current role evidence your
meeting at least two areas of activity and appropriate core knowledge and professional values from the
Dimensions of Practice in the UK PSF (600 words)
https://www.heacademy.ac.uk/sites/default/files/downloads/UKPSF_2011_English.pdf
c. Other Information:
Any other information that you wish to include to support your application, but including plans for your
ongoing CPD activities (200 words)
10% leeway is acceptable on the total word counts indicated above. It is acceptable to vary from the indicative
word count for each sub-section as long as a total word count of around 3000 words maximum is observed. Your
submission will be returned for editing if it is over long.
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Demonstration of Professional and Developmental Activities (Written Submission D1)
a. Introduction:
Introduction: A summary of your academic practice experience, your teaching and learning philosophy
(around 200 words)
b. Meeting the Dimensions of Practice in the UK PSF
A critically reflective account of how your recent experience, professional activities and current role
evidence you meeting at least two of the areas of activity and relevant core knowledge and professional
values in the Dimensions of Practice of the UK PSF (around 600 words)
c. Other Information:
Other Information (200 words)
Please use this space to provide additional information to support your application e.g. activities with professional bodies,
subject associations and project work and your plans for ongoing CPD activity.
Signed
Date of Application
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Details of Referees
Your application must be accompanied by two references. Referees should be experienced staff who are able
to comment knowledgeably, and from first-hand experience, on your current role and any other relevant
activities you have recently undertaken. Referees need to be directly familiar with your practice to validate
the claims made in the evidence grid and in the written submission. We strongly recommend your referees
read your application prior to completing your reference.
One of your referees should be your academic line manager.
It is essential that each of your referees is familiar with the requirements of the UK PSF and is an appropriately
experienced member of staff working for a UK Higher Education Institution. We require at least one of your
referees to be already recognised as a Fellow by the Higher Education. We strongly recommend you
encourage your referees to read the information provided for referees prior to completing the reference.
It is your responsibility to collect the references and submit them with your application.
1st Referee
Name:
Job Title:
Department:
Email address
In what capacity can this individual comment on your professional practice?
2nd Referee
Name:
Job Title:
Department:
Email address
In what capacity can this individual comment on your professional practice?
Reference to support an application for HEA Associate Fellow (D1) via UCS’ PASSPoRT
Scheme CPD Pathway
Applicant Name
PSF Status Applied for
Associate Fellow
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Referee Details
Name:
Job Title:
Department:
Email Address
Capacity in which giving
reference
HEA Status of referee
(circle as applicable)
This reference should be provided by colleagues who are able to:
 comment on the applicant's current/recent role, responsibilities and activities at UCS
 offer a “peer review” of the applicant’s practice
 validate the applicant’s claims made in their D1 written submission
Fellow
Senior Fellow
Principal Fellow
The key aspect of a Fellow (D2) application is that they must demonstrate the full meeting of all the
Dimensions of Practice in the UK PSF
Please comment on the validity of the evidence claimed by the applicant in the Record of Evidence grid and
in the Demonstration of Professional Activity against the Dimensions of Practice (ie the Areas of Activity,
Core Knowledge and Professional Values). We are looking for evidence of commitment to teaching and/or
supporting learning rather than general academic achievements. You are encouraged to organise your
statement and comments around the same identified two Areas of Activity from the Dimensions of
Practice of the UKPSF.
Please use this box to add any further comments that you would like to make
Signature of Referee:
Date:
Note:
Please ensure that your reference is signed and emailed to the applicant so that they can include it with their
written submission. If you wish your reference to be confidential, please email it directly to
christine.smith@ucs.ac.uk indicating the confidential nature of the reference supplied. If you have any
queries about the process please contact Dr Mark Lyne, Head of Quality Enhancement at m.lyne@ucs.ac.uk
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