Document Inventory for Pre-Six Reappointment (Unit 18)

UCSC-APO: 4/04

Use for titles other than Lecturer (e.g., Teacher-Special Programs, Coordinator of Field Work, Supervisor of Teacher Education, etc.) with fewer than 18 quarters in recommending department/unit.

Candidate Material to the Department:
To Division:

Department Completes

Name:

Dept/Unit:

Division:

Within recommending dept/unit:

Current or most recent annual salary rate: $ and Quarters of service to date:
Current or most recent title:
Appt. Basis: 9/9 month 9/12 month %Time:

Proposed Reappointment

Title: Annual Salary Rate: $

Appt. Basis: 9/9 month 9/12 month %Time:

Actual Salary: $ Pay Dates: Service Dates:

NOTE 1: One step salary increase required upon reappointment to a 10th quarter of service in the department if no previous increase given by the recommending department.

NOTE 2: If recommending any salary adjustment other than the 10th quarter increase, include justification in evaluation, including number of steps.

Proposed assignments: List courses and/or equivalencies with corresponding IWCs, or number of courses and/or equivalencies, where appropriate.
These boxex have a limit of 3 lines

Fall
Winter
Spring

Concurrent UC employment: Yes No If yes, provide title, location, and dates:

Review Period:

INDICATE WITH A DOCUMENTS SUBMITTED. INCLUDE EXPLANATION IN DEPARTMENT/UNIT LETTER IF ANY DOCUMENTS ARE NOT SUBMITTED. SUBMIT DOSSIER IN FOLLOWING ORDER:

	Recruitment Compliance: Search # Compliance dated: or Waiver dated:
	Checklist to Assure Fairness
	The Candidate’s Optional Response to Department/Unit Letter
	Department/Unit Evaluation
=>	Optional Material:
	The Candidate's Statement of Pedagogical Philosophy and Goals
	Other Material (e.g., unsolicited letters, etc.)
	Cumulative Biobibliography (include teaching, service, current address, and asterisk courses for which student evaluations were submitted, if any)
	Student Evaluations (since beginning of last approved action, include response rate)

The Candidate's address for correspondence:
This box has a limit of 5 lines

ORIGINAL REVIEW FILE TO DIVISION
ONE COPY OF REVIEW FILE TO BE RETAINED BY DEPARTMENT