APPENDIX F: SAMPLE FORMS

FORM A-1, MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY

                        Teaching Faculty

                        Faculty Counselors

                        Faculty Librarians

                        Department Chairpersons

                        Coordinators

FORM A-2, ILS RESPONSE TO FACULTY MEMBERíS MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY

                        Teaching Faculty

                        Faculty Counselors

                        Faculty Librarians

                        Department Chairpersons

                        Coordinators

FORM B, SUPERVISORY OR PEER OBSERVATION

                        Teaching Faculty

                        Nonteaching Faculty

FORM C, RECIPIENTS OF SERVICE

FORM D-1, EVALUATION CONFERENCE SUMMARY

FORM D-2, DEANíS PERFORMANCE RATING



FORM A-1, MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY
(First Year Teaching Faculty)

Faculty Member                                                                Academic Year                

Division                                                              Department __________________

The following major functional responsibilities are the job requirements for first year teaching faculty. Use an attachment to address how you are fulfilling these responsibilities.  Your commentary should bring to the attention of the ILS any materials or accomplishments  related to the major functional responsibilities (MFRs) about which the ILS may not be aware.  Typically, two or three pages are an adequate length.  Send the original commentary and a copy to the Central File by the due date published by the plan coordinator with copies to your ILS, dean, and, if applicable, coordinator and/or peer.  Make sure that you keep a copy for your own files.

MAJOR FUNCTIONAL RESPONSIBILITIES

 1.        Instructional Content. Submit copies of syllabi with explanation how they incorporate the subject content of appropriate academic rigor as established by the department for each course.

 2.        Instructional Methods. Submit plans for reaching students with different learning styles.

 3.        Class Administrative Duties. Submit samples of policy statements/syllabi distributed to students in writing during first week of class of all course requirements including outline of course objectives, attendance policy, grading system, textbook and other instructional materials, and office hours.

 4.        Departmental Participation. Participate actively and thoughtfully in the department beyond classroom responsibilities.

 5        General Administrative Duties. Fulfills administrative requirements of meeting all scheduled classes or promptly notifying staff of absences; keeping accurate class attendance and assessment records (submit sample); maintaining scheduled office hours; and responding promptly to requests from course coordinators, department chairs, or deans.

 6.        College/Community Service. Indicate possible areas of interest in college-related activities either on- or off-campus.

 7.        Professional Development.  Indicate areas of interest and possible goals for professional development.

                                                                                                                                    
Faculty Member (Signature)                                          Date


FORM A-2, ILS RESPONSE TO FACULTY MEMBERíS MAJOR FUNCTIONAL
RESPONSIBILITIES COMMENTARY (First Year Teaching Faculty)

Faculty Member                                                              Academic Year             _       

Department                                                                   Date                                     

Use an attachment to fully explain any commentary with which you do not concur.  Send the original and a copy to the Central File by the due date published by the plan coordinator with copies to the faculty member, dean, and, if applicable, coordinator and/or peer.  Make sure that you keep a copy for your own files.

1.        Instructional Content. Submit copies of syllabi with explanation how they incorporate the
            subject content of appropriate academic rigor as established by the department for each course.

            9ILS Concurs 9ILS does not concur, with explanation

 2.        Instructional Methods. Submit plans for reaching students with different learning styles.

            9ILS Concurs 9ILS does not concur, with explanation

 3.        Class Administrative Duties. Submit samples of policy statements/syllabi distributed to students in writing during first week of class of all course requirements including outline of course objectives, attendance policy, grading system, textbook and other instructional materials, and office hours.

            9ILS Concurs 9ILS does not concur, with explanation

 4.        Departmental Participation. Participate actively and thoughtfully in the department beyond classroom responsibilities.

            9ILS Concurs 9ILS does not concur, with explanation

 5.        General Administrative Duties. Fulfills administrative requirements of meeting all scheduled classes or promptly notifying staff of absences; keeping accurate class attendance and assessment records (submit sample); maintaining scheduled office hours; and responding promptly to requests from course coordinators, department chairs, or deans.

            9ILS Concurs 9ILS does not concur, with explanation

 6.        College/Community Service. Indicate possible areas of interest in college-related activities either on- or off-campus.

            9ILS Concurs 9ILS does not concur, with explanation

 7.        Professional Development.  Indicate areas of interest and possible goals for professional development.

            9ILS Concurs 9ILS does not concur, with explanation

9.                    8.         ILSís general comments (optional)

 _____________________________________                                                    
ILS (Signature)                                                             Date


FORM A-1, MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY
(Teaching Faculty, Second Year and Beyond)

Faculty Member                                                                Academic Year                

Division                                                              Department                                    

The following major functional responsibilities are the job requirements for teaching faculty. Use an attachment to address how you are fulfilling these responsibilities.  Your commentary should bring to the attention of the ILS any materials or accomplishments  related to the major functional responsibilities (MFRs) about which the ILS may not be aware.  Typically, two or three pages are an adequate length.  Send the original commentary and a copy to the Central File by the due date published by the plan coordinator with copies to your ILS, dean, and, if applicable, coordinator and/or peer.  Make sure that you keep a copy for your own files.

MAJOR FUNCTIONAL RESPONSIBILITIES

 1.        Instructional Content.  Adheres to instructional materials and subject content of appropriate academic rigor as established by the department for each course.

 2.        Instructional Methods.  Explores and uses different teaching methods and strategies to improve classroom instruction and learning outcomes for all students.

 3.        Student Assessment and Evaluation. Carries out reasonable, timely, and equitable student assessment using departmental requirements or guidelines.

 4.        Class Administrative Duties. Informs students in writing during first week of class of all course requirements including outline of course objectives, attendance policy, grading system, textbook and other instructional materials, and office hours.

 5.        Departmental Participation. Participates actively and thoughtfully in department meetings and responsibilities, including but not limited to preparing and updating course syllabi and textbook and course material selection.

 6.        General Administrative Duties. Fulfills administrative requirements of meeting all scheduled classes or promptly notifying staff of absences; keeping accurate class attendance and assessment records; maintaining scheduled office hours; submitting final grades in a timely fashion; and responding promptly to requests from course coordinators, department chairs, or deans.

 7.        College/Community Service. Participates in college-related activities either on- or off-campus.

 8.        Professional Development. Engages in professional activities that enhance instructional effectiveness.

____________________________________                                                             
Faculty Member (Signature)                                          Date


FORM A-2, ILS RESPONSE TO FACULTY MEMBERíS MAJOR FUNCTIONAL
RESPONSIBILITIES COMMENTARY
(Teaching Faculty, Second Year and Beyond)

           Faculty Member                                                              Academic Year                    

           Department                                                                   Date                                       

Use an attachment to fully explain any commentary with which you do not concur.  Send the original and a copy to the Central File by the due date published by the plan coordinator with copies to the faculty member, dean, and, if applicable, coordinator and/or peer.  Make sure that you keep a copy for your own files.

 1.        Instructional Content.  Adheres to instructional materials and subject content of appropriate academic rigor as established by the department for each course.

            9ILS Concurs 9ILS does not concur, with explanation

 2.        Instructional Methods.  Explores and uses different teaching methods and strategies to improve classroom instruction and learning outcomes for all students.

            9ILS Concurs 9ILS does not concur, with explanation

 3.        Student Assessment and Evaluation. Carries out reasonable, timely, and equitable student assessment using departmental requirements or guidelines.

            9ILS Concurs 9ILS does not concur, with explanation

 4.        Class Administrative Duties. Informs students in writing during first week of class of all course requirements including outline of course objectives, attendance policy, grading system, textbook and other instructional materials, and office hours.

            9ILS Concurs 9ILS does not concur, with explanation

5.         Departmental Participation. Participates actively and thoughtfully in department meetings and responsibilities, including but not limited to preparing and updating course syllabi and textbook and course material selection.

            9ILS Concurs 9ILS does not concur, with explanatio

 6.        General Administrative Duties. Fulfills administrative requirements of meeting all scheduled classes or promptly notifying staff of absences; keeping accurate class attendance and assessment records; maintaining scheduled office hours; submitting final grades in a timely fashion; and responding promptly to requests from course coordinators, department chairs, or deans.

            9ILS Concurs 9ILS does not concur, with explanation

7.         College/Community Service. Participates in college-related activities either on- or off-campus.

            9ILS Concurs 9ILS does not concur, with explanation

 8.        Professional Development. Engages in professional activities that enhance instructional effectiveness.

            9ILS Concurs 9ILS does not concur, with explanation

9.                   9.         ILSís general comments (optional)

                                                                                                                      
ILS (Signature)                                                                  Date   


FORM A-1, MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY
(Faculty Counselors)

Faculty Member ____________________________  Academic Year ___________ 

Division __________________________________   Date ____________________

The following major functional responsibilities are the job requirements for faculty counselors. 

Use an attachment to address how you are fulfilling these responsibilities.  Your commentary should bring to the attention of the ILS any materials or accomplishments  related to the major functional responsibilities (MFRs) about which the ILS may not be aware.  Typically, two or three pages are an adequate length.  Send the original commentary and a copy to the Central File by the due date published by the plan coordinator with copies to your ILS, dean, and, if applicable, coordinator and/or peer.  Make sure that you keep a copy for your own files.

MAJOR FUNCTIONAL RESPONSIBILITIES

 1.        Instructional Content.  Adheres to instructional materials and subject content of appropriate academic rigor as established by the department for each course.

 2.        Instructional Methods.  Explores and uses different teaching methods and strategies to improve classroom instruction and learning outcomes for all students.

 3.        Student Assessment and Evaluation. Carries out reasonable, timely, and equitable student assessment using departmental requirements or guidelines.

 4.        Class Administrative Duties. Informs students in writing during first week of class of all course requirements including outline of course objectives, attendance policy, grading system, textbook and other instructional materials, and office hours.

 5.        Departmental Participation. Participates actively and thoughtfully in department meetings and responsibilities, including but not limited to preparing and updating course syllabi and textbook and course material selection.

 6.        General Administrative Duties. Fulfills administrative requirements of meeting all scheduled classes or promptly notifying staff of absences; keeping accurate class attendance and assessment records; maintaining scheduled office hours; submitting final grades in a timely fashion; and responding promptly to requests from course coordinators, department chairs, or deans.

 7.        College/Community Service. Participates in college-related activities either on- or off-campus.

 8.        Professional Development. Engages in professional activities that enhance instructional effectiveness.

____________________________________          _________________
Faculty Member (Signature)                                        Date


FORM A-2, ILS RESPONSE TO FACULTY MEMBERíS MAJOR FUNCTIONAL
RESPONSIBILITIES COMMENTARY

(Faculty Counselors)                                                                                                  Page 1 of 2

Faculty Member ____________________________   Academic Year _______________ 

Department ________________________________   Date _______________________ 


FORM A-2, ILS RESPONSE TO FACULTY MEMBERíS MAJOR FUNCTIONAL RESPONSIBILITIES COMMENTARY

(Teaching Faculty, Second Year and Beyond)                                                         Page 2 of 2

 

 8.        Professional Development. Engages in professional activities that enhance instructional effectiveness.

            9ILS Concurs 9ILS does not concur, with explanation


9.          ILSís general comments (optional)

_______________________________________      __________________
ILS (Signature)                                                             Date