Pre-Six Lecturer Assessment/Reappointment Form
UCSC:APO rev 12/08
For reappointment to all other pre-six Unit 18 titles, use the Document Inventory for Pre-Six Reappointment (instructions)
Also use for Educator without Salary title
Candidate Material to the Department:
Date To Division:
Date To Division:
Department/Unit Completes
Name: |
Division: |
Dept/Unit: |
Within recommending dept/unit - Current or most recent Annual Salary Rate: $ |
Quarters of service to date: |
Proposed Reappointment
Recruitment Compliance: Search # Compliance dated: or Waiver dated: |
Proposed annual salary rate: $ Proposed % time Proposed actual salary: $ |
Proposed period of appointment (maximum Pre-6 reappointment term is 3 academic years) |
Proposed assignments: List courses and/or equivalencies with corresponding IWCs, and designate nature of appointment These boxes have a limit of 3 lines |
Fall | |
Winter | |
Spring |
Assessment of the Candidate |
Review Period: |
List courses for which student evaluations were considered and/or note with an asterisk (*) on CV This box has a limit of 3 lines |
OR There are currently no student evaluations for the review period available for assessment |
Teaching ability and/or performance of other assigned duties has been assessed and meets competency standard | |
The Candidate submitted OPTIONAL material that was considered in this assessment (e.g., response to this assessment, instructional materials, statement of pedagogical philosophy and goals, unsolicited letters, etc.) | |
The Candidate’s address for correspondence: This box has a limit of 3 lines |
X______________________________________________________ ______________
Signature of Department Chair/Unit Head verifies the assessment Date
Prior and/or Concurrent UC Employment: If YES, provide title, location, and dates: This box has a limit of 3 lines |
- ASSESSMENT FILE RETAINED BY DEPARTMENT/UNIT: copies of assessment form, CV, checklist, and letter of justification (if any); and original student evaluations, and optional materials (if any)
- FORWARD TO DIVISION: original assessment form, checklist, CV, and letter of justification (if any)
Division Completes
Annual Salary Rate: |
Note step increase and reason, if applicable: |
Appt. Basis: 9/9 month 9/12 month %Time: Actual Salary: $ |
Pay Dates Service Dates |
Is 9/12 basis the result of averaging due to assignments outside the recommending department/program/unit?: Yes or No If yes, note other department assignments and service dates: This box has a limit of 3 lines |