Assistant Professor Data Summary

NAME:	DEPARTMENT:	REVIEW #:

(last name, first)

TYPE OF REVIEW(S)	Appointment	Appraisal Recommendation
(Check ALL applicable categories)	Renewal of Appointment	Favorable
Recommend for	With Reservations
Recommend Against	Unfavorable
Merit	Unfavorable (non-renewal)
Promotion	Change in Series
"Eight-Year Limit" Review	Change in Department
Joint Appointment
Secondary Department:

present status	proposed status

Rank & Step:

Salary Rate:

Years at Rank: Years at Step:

Years toward

Eight-Year Limit:

Rank & Step:

Salary Rate:

Effective Date:

A CURRENT, UP TO DATE HISTORY RECORD IS REQUIRED

INSERT IMMEDIATELY FOLLOWING THIS PAGE

To be completed by Dean's Office of School or College having jurisdiction:

This action:	Dean assumes that with respect to the School or College, this action:
does not require Council on Academic Personnel review	represents final action
bears the required Council on Academic Personnel comment	requires final action, off-scale complies with previous RTSS
requires Chancellor's approval for the acceleration
requires submission by the Academic Personnel Office to Council on Academic Personnel	requires Chancellor's approval for the promotion
requires Chancellor's approval on off-scale
requires Chancellor's approval on retroactivity
Dean has no authority. Chancellor approval required

DEAN'S ACTION:	DATE:

CHANCELLOR'S ACTION:	DATE:

ASSISTANT PROFESSOR DATA SUMMARY	NAME:

CERTIFICATION OF COMPLIANCE WITH BYLAW 55 (If faculty vote is required in more than one department, attach separate certification for each department).

DEPARTMENT:

(Please make all entries in the columns to the right)

REVIEW #	REVIEW #	REVIEW #	REVIEW #	REVIEW #
Report to Vote:	TYPE:

TYPE:

TYPE:

TYPE:

TYPE:

Indicate class of eligible voters under approved departmental procedures
for implementation of Bylaw 55.

Examples: elected committee, tenure staff, entire staff, etc.

Number eligible
to vote ___________.

Motion voted upon as checked under "Type of Review(s)." page 1, and proposed effective date.

Effective:

Effective:

Effective:

Effective:

Effective:
Aye__________

Nay__________

Abstain_______

Absent________

Other_________

Explain

If JOINT APPOINTMENT, secondary department waiver in effective from to .

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

BIOGRAPHICAL DATA:

Degree	Date	Institution

STATUS PRIOR TO APPOINTMENT (include current UCLA affiliation, if applicable, i.e. visiting):

Institution	Title	Salary / 9mo. 11 mo.
/

INFORMATION CONCERNING INDIVIDUALS SUPERVISED BY CANDIDATE

Current status of those who have

Completed degree (1)

Number currently advanced to candidacy (1)

Number currently working as Postdoctoral Scholars
Title	Institutional Affiliation

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

INFORMATION REGARDING TEACHING RECORD SINCE LAST REVIEW OR FOR PROMOTION/8 YEAR LIMIT ACTION, CUMULATIVE SINCE APPOINTMENT

TEACHING RECORD

COURSE PROGRAM CARRIED BY CANDIDATE

Term,

Year	Course No. (1)	Title of Course	Required (2)	Enrollment	Other
Faculty
Participants (3)

Please attach additional sheet(s) if more space for courses is needed.

OTHER TEACHING ACTIVITIES

(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

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

INFORMATION REGARDING SERVICE AND PROFESSIONAL ACTIVITY SINCE LAST REVIEW OR FOR PROMOTION/8 YEAR LIMIT ACTION, CUMULATIVE SINCE APPOINTMENT

TEACHING RECORD

UNIVERSITY COMMITTEE SERVICE

Service on Academic Senate Committees:

Committee	Period of Service

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)

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

INFORMATION REGARDING SERVICE AND PROFESSIONAL ACTIVITY SINCE LAST REVIEW OR FOR PROMOTION/8 YEAR LIMIT ACTION, CUMULATIVE SINCE APPOINTMENT

HONORS AND SPECIAL RECOGNITION RECEIVED

Description	Dates

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)

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

INFORMATION REGARDING SERVICE AND PROFESSIONAL ACTIVITY SINCE LAST REVIEW OR FOR PROMOTION/8 YEAR LIMIT ACTION, CUMULATIVE SINCE APPOINTMENT

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)

ASSISTANT PROFESSOR DATA SUMMARY

GUIDE TO BIBLIOGRAPHY PREPARATION FOR ASSISTANT PROFESSOR ACTIONS

Complete bibliographies indicating prior submissions. If a current published item was listed in an earlier submission as "in preparation" or "in press," it should be so indicated. Minimum submissions are as follows:

Action	Bibliography	Publications
Apppointment	Complete	as requested by Chair or Dean
Merit Increase

Renewal of Appointment	Cumulative since appointment	as requested by Chair or Dean
Fourth Year Appraisal	Cumulative since appointment	submit all publications
Promotion

"Eight-Year Limit" Review

Non-Renewal of Appointment	Cumulative since appointment	submit all publications

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)

BOOKS

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 authors' 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

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

CANDIDATE'S CERTIFICATION & INVENTORY OF ADDED MATERIALS PRIOR TO DETERMINATION OF DEPARTMENTAL RECOMMENDATION

I CERTIFY THAT FOR REVIEW # :

Under Section 220-80-c of the Academic Personnel Manual:

I was informed of the impending review for the personnel action and of the review process (through access to APM Sections 210-1 and 220).

I was provided the opportunity to ask questions, supply information and evidence, make any desired additions, and if relevant in this personnel action, suggest names for solicitation of letter of evaluation and to provide, in writing, names of persons (within and outside UCLA), who in my view, may not provide objective evaluations. (If such information provided, list names below.)

Under Section 220-80-d of the Academic Personnel Manual:

I inspected the data set forth on pages 3-7 and the bibliography. My initials following the entries on those pages indicate my concurrence in the completeness and accuracy of the data. (Any items corrected by me or added at my request are inventoried below).

I had the opportunity to receive redacted copies of the confidential documents in this file.

I had the opportunity to provide a written statement for inclusion in this file in response to or commenting upon material in the file (If such a statement was provided, it is listed below)

Name

Date

Items I have corrected and items and statements I have added.

ASSISTANT PROFESSOR DATA SUMMARY	REVIEW # NAME:

CANDIDATE'S CERTIFICATION AFTER DETERMINATION OF DEPARTMENTAL RECOMMENDATION

I CERTIFY THAT FOR REVIEW # :

Under section 220-80-e of the Academic Personnel Manual:

I was informed of:

the departmental recommendation and of the substance of the departmental evaluations under each of the applicable criteria. Upon request, a copy of the departmental recommendation was supplied to me.

the departmental vote.

the right to make written comments on the departmental recommendation and to direct transmittal of these comments to the Chair or Dean for inclusion in this file.

IV)	the time limit for submission of comments under III above.

Name

Date

ASSISTANT PROFESSOR DATA SUMMARY

brendam

1999-05-07

UCLA