Expansion to a Distant Campus
Appendix F
Program Name:
Personnel Responsibilities TEMPLATE (A1.08, A2.05, A2.09, A2.12)
List below the program director, medical director, principal faculty and administrative support staff. Identify
their responsibilities from the list provided. Indicate the name/location of the distant campus and indicate to
which campus the individuals have their primary assignment (this form is designed to accommodate up to
four distant campuses).
Complete additional copies of this template as needed to accommodate the number of individuals involved.
IF you complete more than one template, save each under a different name and indicate in the comments
section that more than one template was used.
Responsibilities
Assigned to Main
Campus
Assigned to
Distant Campus
Assigned to
Distant Campus
Assigned to
Distant Campus
Assigned to
Distant Campus
Academic Advising
Administration
Administrative
assistance
Individual Name and Title (use abbreviations for title)
Expansion to a Distant Campus: Personnel
Accreditation
activities
Clinical practice
Clinical site
development
Clinical site
monitoring
Coordination of
instruction
Curriculum
development
Curriculum
evaluation
Faculty
coordination
Faculty
development
Program
evaluation
Secretarial
Scholarly activities
Student advising/
Counseling (non
academic)
Student
recruitment
Student evaluation
Student selection
Teaching and
instruction
Other:
Other:
Other:
Other:
Comments:
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