associate and full professor

Five-year Review Data Summary

NAME:	DEPARTMENT:

(last name, first)

present status

Rank & Step:

Salary Rate:

Years at Rank: Years at Step:

Effective Date:

A CURRENT, UP-TO-DATE HISTORY RECORD IS REQUIRED

INSERT IMMEDIATELY FOLLOWING THIS PAGE

TYPE OF NEXT REQUIRED REVIEW:	Merit
Promotion
Merit to Step 6
Advancement to Above Scale

DEAN'S ACTION: DATE:

CHANCELLOR'S ACTION: DATE:

NOT ALL PAGES ARE REQURED. See the CALL, Appendix 12 for detailed instructions. Review is conducted during the spring of the fifth year. The effective date is July 1st immediately following this period.

FIVE-YEAR REVIEW DATA SUMMARY NAME:

TEACHING RECORD

COURSE PROGRAM CARRIED BY CANDIDATE DURING PRIOR ACADEMIC YEAR AND FALL OF CURRENT ACADEMIC YEAR OR SINCE LAST ADVANCEMENT. WHICHEVER PERIOD IS THE LONGER, BUT WITH A REQUIRED MAXIMUM REPORTING PERIOD OF FIVE YEARS.

Term,

Year	Course No. (1)	Title of Course	Required (2)	Enroll-ment	Other
Faculty
Participants (3)
Please attach additional sheet(s) as necessary

(1) If no undergraduate course is listed, please append statement of rationale for assignment of courses made to the candidate for the indicated period.

(2) Required for a major or to fulfill a lower division requirement.

(3) If other faculty participated, please append statement describing character and extent of candidate's participation.

FIVE-YEAR REVIEW DATA SUMMARY NAME:

OTHER TEACHING ACTIVITIES:

GRADUATES WHO HAVE COMPLETED Ph.D. (OR OTHER TERMINAL ADVANCED DEGREE) AT UC DURING THE PRIOR FIVE-YEAR PERIOD UNDER PRINCIPAL SUPERVISION OF FACULTY MEMBER (THAT IS, FACULTY MEMBER WAS CHAIR OF DOCTORAL COMMITTEE):

NUMBER DURING SPECIFIED PERIOD:

CURRENT STATUS OF THESE DEGREE HOLDERS (IF KNOWN):

Name	Year Ph.D. Granted	Institutional Affiliation	Title

GRADUATES ADVANCED TO CANDIDACY FOR THE Ph.D. (OR CANDIDATES FOR OTHER TERMINAL ADVANCED DEGREES) CURRENTLY WORKING UNDER THE PRINCIPAL SUPERVISION OF FACULTY MEMBER (THAT IS, FACULTY MEMBER IS CHAIR OF DOCTORAL COMMITTTEE):

Name	Year Advanced to Candidacy

FIVE-YEAR REVIEW DATA SUMMARY NAME:
INFORMATION REGARDING SERVICE AND PROFESSIONAL ACTIVITY FOR THE RELEVANT PERIOD FOR ALL PROFESSORIAL SERIES.

UNIVERSITY COMMITTEE SERVICE

(1) Service on Academic Senate Committees:

Committee	Period of Service

(2) Other Committee Service:

Committee	Period of Service

COMMUNITY SERVICE ACTIVITIES (e.g. providing service related to the improvement of elementary and secondary education)

Description	Date (s)

HONORS AND SPECIAL RECOGNITION RECEIVED

Description	Date (s)

FELLOWSHIP AND RESEARCH GRANTS RECEIVED

Agency & Number

Title PI or co-PI
(name PI if you are not)	% effort	Duration of Grant	Direct costs (your component only,
if multiple co-PIs)

FIVE-YEAR REVIEW DATA SUMMARY NAME:

PROFESSIONAL ACTIVITIES DURING THE RELEVANT PERIOD

ACTIVITIES IN SCHOLARLY AND PROFESSIONAL SOCIETIES (e.g. serving as a committee member or as an officer of scholarly or professional organization, or providing professional services to such organizations)

EDITORIAL SERVICES TO SCHOLARLY PUBLICATIONS (e.g. serving as a reviewer or editor)

CONSULTING ACTIVITIES (e.g. providing professional, managerial, or technical services to individual clients, commercial entities, non-profit organizations, and governmental agencies; testifying as an expert in legislative, administrative and judicial proceedings)

OTHER PROFESSIONAL ACTIVITIES (e.g. practicing a profession on a part time basis; presenting invited lectures or papers; participating in or accepting a commission for musical, dramatic, dance or other artistic activity, performance, or event)

FIVE-YEAR REVIEW DATA SUMMARY

GUIDE TO BIBLIOGRAPHY PREPARATION

Complete Bibliographies Indicating Prior Submissions.

If possible, the candidate's complete bibliography should be included if appropriate. In a current published item was listed in an earlier submission as "in preparation" or "in press," it should be so indicated.

Categorized Bibliographies:

Entries should be identified by categories, such as Books, Monographs, Published Research Papers, Published Articles, Abstracts, and Book Reviews. Since categories will vary among the disciplines, department may wish to adopt their own categories (the Council on Academic Personnel recommends departments consider providing bibliographic items by category. See example #2, below.)

Example #1	Smith, R., Jones, H., and Jackson, K., "A Study of the Perodian Process," J. Chem. Phys., 14:325-30 (1984)

(RESEARCH PAPER)

Example #2	RESEARCH PAPERS

Smith, R., Jones, H., and Jackson, K., "A Study of the Perodian Process," J. Chem. Phys., 14:325-30 (1984)

Page Numbers:

Both first and last page should be cited.

Edited Works

In instances where editors contribute various writing such as introductions, summaries, chapters, etc. to the works with edit, a description of such writings, including page numbers should be included as part of the citation of each edited work.

Joint Authorship

The author's names should be listed as they appear on the publications.

Note

All publications added since the last review should be bracketed in the left margin.

DO NOT INCLUDE THIS PAGE IN THE DATA SUMMARY

FIVE-YEAR REVIEW DATA SUMMARY NAME:

FACULTY MEMBER'S CERTIFICATION TO ACCOMPANY TRANSMITTAL OF FIVE-YEAR REVIEW

I CERTIFY THAT

I was informed that a five-year review was to be conducted, was given opportunity to submit material to be considered in the review and consulted the Department Chair about the review.

I was infomed of the outcome of the review, was give the opportunity to receive a copy of the Departmental Chair's letter transmitting the review, and was given the opportunity to provide a written comment on the review to be included in the file.

Name

Date

1

ASSISTANT PROFESSOR DATA SUMMARY

brendam

1999-06-03

UCLA