FACULTY ACTIVITY REPORT/SELF EVALUATION

List activities for April 1, 2005 through March 31, 2006

(Teaching during spring, summer, fall 2005)

Date Submitted:

Section I. Professional Background

Name:

Department:

Rank and date appointed to that Rank:

Office address:

Phone number:

Email:

Professional degrees and certifications (earned in past year):

Section II: Teaching

Term	Course Prefix and	Credit Hours	Course Title	Course Enroll- ments	SIE
Term	Course Prefix and	Credit Hours	Course Title	Course Enroll- ments	Total		Global Item
	Number				No. Responses	Score		No. Responses	Score
Spring 05
Spring 05
Spring 05
Spring 05
Summer 05
Summer 05
Summer 05
Fall 05
Fall 05
Fall 05
Fall 05

*Global Item

College of Administrative Science – Item 20 College of Liberal Arts- Item 15

College of Engineering – Item 18 College of Nursing – Item 19

College of Science – Item 15 Library – Item 15

Teaching-related grants and funding:

(For each item include: authors, title, awarding organization, date submitted, time period award, dollar value, and status (awarded, under review, rejected))

Advising and Mentoring Students

• Student advisees (give number)

Undergraduate	Masters Directly Supervised	PhD Directly Supervised	Masters Committees Other Than Chair or Directly Supervised	PhD Committees Other Than Chair or Directly Supervised

• Theses and dissertations completed under your supervision:

(Give student name, title of work, department, term completed and level of degree)

Name	Title of Work	Department	Term Completed	Degree

Students Supported on Grants and Contracts (give names and semesters)

Undergraduates
Name	Semester


Graduate Students
Name	Semester

Other Instructional Activities

· Describe your experiments and innovations this year with respect to:

(1) Programs of instruction and instructional methods

(2) Applications of new learning approaches, technologies, and equipment.

· Include publications you have authored, for example, textbooks, teaching manuals, instructional software, computer programs, books of readings, chapters in textbooks, articles in pedagogical journals and written cases with instructional material.

Curriculum development

Coordination of multiple sections in an academic discipline.

Section III. Research, Creative, and Scholarly Activity

hPublications:

(Give status such as submitted, accepted. Include complete citation for each and indicate whether it was peer-reviewed.)

hPerformances, exhibitions, papers, session participation, or creative achievements:

hSponsored activities:

(Investigators (identify principal investigator), title, awarding organization, date submitted, time period of grant or contract, dollar value, status: (awarded, under review, rejected))

hProjects under preparation:

h Other activities:

Section IV: Service

hService to the institution (department, college, and university):

hService to the discipline (professional organizations and scholarly societies):

h Professional service to the public (include service grants or contracts as principal investigator, services provided through a Research Unit (Institutes, Laboratories, Centers and Consortia), and other public service activities such as clinical practice, continuing education teaching, public policy guidance, public presentations, economic development activities, and studies for governments, other public institutions, companies):

hOther service activities (Consultation, etc):

Section V. Honors, Awards, and Other Forms of Special Recognition

(such as commendations that have been received in the execution of

teaching, scholarly activities, and service)

Section VI. Professional Development

(Involvement in professional meetings, professional development

program, executive development programs, extension (include any

planned activities)):

Section VII. Self-Evaluation

(Refer to your goals stated in the previous years’ section on

"goals for the coming year" in teaching, research and service

paragraphs. Provide a self-appraisal and explanation as well

as evidence of accomplishments and explanations for problems.

The self-assessment essay should cover teaching, research,

service, and professional activities).

Section VIII. Personal Goals for the Coming Year

(Discuss goals in teaching, research, service, and professional development)

SECTION IX: Current Faculty Curriculum Vitae (Attach copy) (Vitae Should cover at least the last five years)

TO: Dean

FROM: Department Chair

RE: Annual (May 15, 2005-May 14, 2006) Performance Evaluation for

DATE:

	Exceptional Performance	Above Average Performance	Average Performance	Below Average Performance	Unacceptable Performance
Teaching
Research
Service
Overall

Teaching:

Research:

Service to institution, discipline and public:

Overall:

Department Chair Signature _________________________________Date___________

Faculty Acknowledgment: I have had the opportunity to discuss this evaluation with the department chair. I understand that I have the privilege of responding in writing to this evaluation and that such response will be attached to the evaluation.

Faculty Signature: _____________________________Date

NOTE: This performance evaluation is one of the factors considered in determining reappointment, tenure, promotion, merit pay, and support for development, renewal, and participation in academic organizations.

Distribution: Original - Personnel file, Office of the Dean

Copy 1- Faculty Member

Copy 2 - Office of Provost and Vice President for Academic Affairs

Cumulative Curriculum Vitae Accompanying

Faculty Activity Report/Self Evaluation

I. Professional Background

Name:

Rank and Year Appointed to that Rank:

Year of Appointment to Graduate Faculty if applicable:

Department:

Office Address:

Academic Specialty (ies):

Degrees (include all degrees: bachelors, masters, and doctorate), (include title of degree, year awarded, institution, major, minor, and dissertation title):

Professional certification: (If none, delete this entry): (include certificate name, year, source):

Nonacademic professional experience: (If none, delete this entry): (List years, position, organization)

Academic experience: (If none, delete this entry): (List years, rank, university)

II. Teaching Activities: Summary list of courses taught, theses advised

III. Research, Creative, and Scholarly Activity:

(List publications chronologically, by category, including authors, title, journal, volume, page, year published)

§ Books:

§ Refereed Journal Articles:

§ Abstracts and Papers Delivered at Professional Meetings:

§ Other Publications:

§ Performances:

§ Exhibitions:

§ Invited Colloquia, Seminars and Presentations:

§ Research Grants and Contracts Received: (include agency or

foundation, title, dollar amount, time period)

IV. Service Activities (include service to institution, profession, discipline, other):

V. Honors, Awards, and Special Recognitions: