Academic Staff Performance Review
“Form A”
FORM A
To be completed by:
Staff on probation in continuing posts
Staff in convertible posts
Staff progressing through a salary scale within a classification
Staff likely to be applicants for promotion within the next
three years
Heads/Deputy Heads of Academic Organisational Units, and academic supervisors
Any other staff member who chooses to complete Form A instead of Form B
IMPORTANT
This form should be completed in the following format
and with reference to the “Guide to Form A”.
All staff should complete Section I, Section II and
Section III, and provide an up-to-date curriculum vitae.
Revised: November 2007
Section I1. FULL NAME (include title)
2. AOU (DEPARTMENT/SCHOOL/COST CENTRE)
3. ACADEMIC AND PROFESSIONAL QUALIFICATIONS (refer to Note #3 in Guide to
Form A)
4. CURRENT HIGHER DEGREE ENROLMENT OR OTHER POSTGRADUATE ENROLMENT (refer to Note #4 in Guide to Form A)
5. CURRENT POSITION (eg Lecturer in English, Senior Lecturer in Physiology)
6. DATE OF APPOINTMENT/PROMOTION TO CURRENT POSITION
7. TYPE OF APPOINTMENT (Fixed-term/Convertible/Continuing)
8. APPOINTMENT FRACTION(Full-time/Part-time) (refer to Note #8 in Guide to Form A)
9. DATE(S) OF PREVIOUS ACADEMIC PERFORMANCE REVIEW(S)(refer to Note #9 in Guide to Form A)
10. NAME OF CURRENT SUPERVISOR
11. PREVIOUS POSITIONS HELD AT FLINDERS UNIVERSITY, INCLUDING PROMOTIONS
Date:
Position:
Date:
Position:
Date:
Position:
Section II12.TEACHING AND RELATED DUTIES
12.1Activities since last review (refer to Note #12.1 in Guide to Form A)
12.2Proposed activities for current year(refer to Note #12.2 in Guide to Form A)
12.3Future plans (refer to Note #12.3 in Guide to Form A)
13.RESEARCH AND/OR CREATIVE ACTIVITY
13.1Activities since last review (refer to Note #13.1 in Guide to Form A)
13.2Proposed activities for current year (refer to Note #13.2 in Guide to Form A)
13.3Future plans (refer to Note #13.3 in Guide to Form A)
14.ADMINISTRATION AND SERVICE TO THE UNIVERSITY (refer to Note #14 in Guide to Form A)
14.1Activities since last review (refer to Note #14.1 in Guide to Form A)
14.2Proposed activities for current year (refer to Note #14.2 in Guide to Form A)
14.3Future plans (refer to Note #14.3 in Guide to Form A)
15.PROFESSIONAL ACTIVITYINCLUDING SERVICE TO THE COMMUNITY(refer to Note #15 in Guide to Form A)
15.1Activities since last review (refer to Note #15.1 in Guide to Form A)
15.2Proposed activities for current year (refer to Note #15.2 in Guide to Form A)
15.3Future plans (refer to Note #15.3 in Guide to Form A)
Section III16.PERIODS OF LEAVE OR OTHER ABSENCES FROM THE UNIVERSITY (refer to Note #16 in Guide to Form A)
17.SPECIAL CIRCUMSTANCES (refer to Note #17 in Guide to Form A)
18.ORIENTATION AND TRAINING
18.1Mandatory training(refer to Note #18.1 in Guide to Form A)
18.2Other training(refer to Note #18.2 in Guide to Form A)
19.ACHIEVEMENTS/PROBLEMS WITH RESPECT TO PREVIOUS YEAR’S GOALS (refer to Note #19 in Guide to Form A)
20.SUPPORT/TRAINING REQUIRED TO ACHIEVE CURRENT YEAR’S ACTIVITIES AND GOALS (refer to Note #20 in Guide to Form A)
21.PRINCIPAL GOALS FOR THE NEXT TWO - THREE YEARS AND LONGER TERM(refer to Note #21 in Guide to Form A)
22.SUPPORT/TRAINING REQUIRED TO ACHIEVE MEDIUM/LONGER TERM ACTIVITIES AND GOALS(refer to Note #22 in Guide to Form A)
23.ISSUES/OBSTACLES TO ACHIEVING GOALS/OUTCOMES(refer to Note #23 in Guide to Form A)
24.OCCUPATIONAL HEALTH AND SAFETY RESPONSIBILITIES (refer to Note #24 in Guide to Form A)
25.SIGNATURE AND DATE(refer to Note #25 in Guide to Form A)
…………………………………………………………………..……………………………..
Staff member’ssignatureDate
STAFF MEMBER’S CHECKLIST:
□ SETS undertaken (and copy of SET reports provided) as required
□ Results of peer feedback/review on teaching provided if undertaken
□ Outside professional activities approved and documented as required
□ Orientation and training requirements fulfilled
Please forward your completed Form A, curriculumvitae, and attachments to your supervisor by the agreed deadline.
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