Academic Action Summary for Merit Review and/or Re-Appointment (Short Form)

UCSC-APO: 08/03

Candidate Material to the Department:
Date To Division:

For advancement from Assistant Professor 1 to 2, 2 to 3, 3 to 4, 4 to 5;
Associate Professor 1 to 2, 2 to 3, 3 to 4; and
Professor 1 to 2, 2 to 3, 3 to 4, 4 to 5 ONLY
(Includes In-Residence and Adjunct Series)

Department Completes:

Name:

Division:

Dept/Unit:

Present Status:	Status Proposed By Department
Rank: Step: %Time: Basis: 9 month 11 month	Rank: Step: %Time: Basis: 9 month 11 month
Annual Salary Rate: $ If off-scale,amount: $	Annual Salary Rate: $ If off-scale,amount: $
Years at Rank Years at Step:	Effective Date:
Review Period: thru

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

	Checklist to Assure Fairness
	Vote/Recommendation Page
	The Candidate's Optional Response to Department Evaluation
	Department Evaluation Sheet. Provide a copy to the Candidate.
	The Candidate's Optional Statement
	Sabbatical Leave Report (if leave was taken during the review period)
	Unsolicited Material (other material which the Candidate wishes to have included in the review file) See CAPM 406.220
	Cumulative Biobibliography See Campus Biobibliography Guidelines
=>	Student Letters (if solicited):
	Sample copy of solicitation letter
	Representative sample of names from course list must be used
	Student Evaluations for review period (Please asterisk those submitted on Biobibliography)
	The Candidate's address for correspondence: This box has a limit of 3 lines

ORIGINAL REVIEW FILE FOR APPROVING AUTHORITY
ONE COPY OF REVIEW FILE FOR DIVISION (IF CP/EVC Authority)
ONE COPY OF REVIEW FILE TO BE RETAINED BY DEPARTMENT

Academic Action Summary for Merit Review and/or Re-Appointment (Short Form)

Department Completes:

Present Status:

Status Proposed By Department