FACULTY ANNUAL (SELF ASSESSMENT) REPORT

(School/ Department/Program) ______

Academic Year: ______

Faculty Name: ______

TEACHING

Courses:

Number Student New

Number Title Students Evaluation Prep

Fall Semester:

______

______

______

______

______

# Fall Advisees ______

Spring Semester:

______

______

______

______

______

# Spring Advisees ______

Summer Sessions:

______

______

______

______

Independent Studies:

Thesis/Dissertation:

TEACHING

1.1 Currency of Course Content:

1. 
2. 
3. 

1.2 Instructional Design, Delivery, & Improvement:

4. 
5. 
6. 

1.3 Course Management:

7. 
8. 
9. 

1.4 Faculty Pedagogical Development/Collaboration:

10. 
11. 
12. 

1.5 Contributions to Learning and Outcome Assessments:

13. 
14. 
15. 

1.6 Student Advising:

16. 
17. 
18. 

1.7 Other:

19. 
20. 
21. 
22. 

SCHOLARLY ACTIVITY

Report the number of activities for each item.

Publications: [List appropriately citing all coauthors and publication date.]

Books: [Include Publishing Company]

Articles in Books:

Journals: [Indicate Refereed or Invited]

Chapters: [Indicate: 1) Publication Source; 2) Refereed or Invited]

Proceedings: [Indicate: 1) National, Regional, State, Local; 2) Refereed or Invited]

Other: [e.g.: Student or Instructor Manuals, Book Reviews, Edited Proceedings, Newsletters

]

Presentations: [Indicate: 1) Conference; 2) National, Regional, State, Local; 3) Refereed or Invited; 4) Co-presenters; 5) Date]

Conferences Attended: [Indicate: 1) Dates; 2) Location]

Conference Participation: [e.g.: Reviewer, Discussant, Panel Member, Session Chair]

Grants: [Indicate: 1) Title; 2) Agency; 3) Submitted, Under Consideration, Received; 4) Dates of Grant]

Research in Process: [Indicate: 1) Title or Nature of Research; 2) Stage of Development; 3) Anticipated Completion Date; 4) Anticipated Publication Outlet]

SERVICE

Professional Associations:

Memberships:

Offices Held: [Indicate: 1) Dates; 2) Elected or Appointed]

Department/School/University:

Number of Students Advised: ______

Faculty Senate: [Indicate: 1) Dates; 2) Unit

Represented]

Committees: [Indicate: 1) University, School, Department; 2) Standing or Special, 3) Chair or Member; 4) Dates]

Professional Community Outreach:

Continuing Education Instruction: [Indicate: 1) Dates; 2) Number of Attendees 3) Sponsoring Agency]

Non-Paid Consulting:

Professional Community Outreach: (Continued)

Media Interviews and Appearances: [Indicate: 1) Date; 2) Media]

Community Memberships:

Other:

TOTAL

Faculty ______

Signature Date

Dept. Chair ______

Signature Date

5-Year Peer Assessment Overview Matrix

(Matrix is only an overview of the rating which was assigned. Matrix should accompany the faculty each year to the peer assessment committee, chair assessment and any personnel actions.)

Instructor: Jane Doe, Professor of Art

Department: Performing and Fine Art

Year / 2009 / 2010 / 2011 / 2012 / 2013
1.1 Currency of Course Content / M
1.2 Instructional Design/ Delivery and Improvement / M
1.3 Course Management / M
1.4 Faculty Pedagogical Development/Collaboration / N
1.5 Contributions to Learning Outcomes/ Assessments / M
1.6 Student Advising / E
1.7 Other / NA
2.1 Currency and Professional Development / E
2.2 Contributions to Practice / M
2.3 Discipline Based Research/Creative / E
2.4 Pedagogical Research / M
2.5 Grant Writing / NA
2.6 Other / NA
3.1 Dept. Service / E
3.2 School/College Service / E
3.3 University Service / E
3.4 Community &State Service / E
3.5 Service to Profession or Discipline / M
3.6 Other / NA
Peer Reviewer Initials
Faculty Initials

LEGEND: E=Exceeds Expectations; M=Meets Expectations; N=Needs Improvement; NA=Not applicable

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