PART A: Nomination Cover Page
Nominee contact details:
Title
First and last name
Position title
School / Faculty
Email address
Telephone
Fellowship focus:
Fellowship title
(20 words max)
Discipline focus of Fellowship, if relevant
(use keywords)
Educational issue(s) to be addressed in Fellowship (use keywords)
Student strategy initiative(s) to be addressed in Fellowship (use keywords)
Level of funding requested
$25,000 (as one of two Faculty Fellows) or
$50,000 (as sole Faculty Fellow)
Preferred start date
(indicate your preferred start date in 2018 to undertake the 12-month Fellowship)
(must be before May 1)
Abstract
In 150 words or less, describe the intended aim and key activities of the proposed project
Benefit to school and/or faculty
In 150 words or less, describe the benefits of the proposed project for your school and/or faculty
Benefit to students
In 150 words or less, describe the benefits of the proposed project for UQ students
Nominee’s Declaration:
I agree to be nominated for a UQ Teaching Fellowship and agree to the conditions of the Fellowship.
I note that one Fellowship from each Faculty is reserved for reserved for a project that converts a course, or a suite of courses, to blended delivery mode.
Please tick this box if the project fulfils the criterion for a reserved Fellowship ☐
Signature / Date
Faculty Associate Dean (Academic) Certification:
I support this nomination on the basis of the attached documentation. I undertake to support this nominee in the activities associated with the UQ Teaching Fellowship in accordance with the attached statement of support. I confirm that the information above is true and correct and that the nominee named on this form is currently a staff member of this institution.
I note that one Fellowship from each Faculty is reserved for reserved for a project that converts a course, or a suite of courses, to blended delivery mode.
Please tick this box if the project fulfils the criterion for a reserved Fellowship ☐
Associate Dean (Academic) / Faculty
Signature / Date
Head of School Certification:
I certify that:
i) The program of activities, if funded under this application, can be accommodated within the general facilities in my organisational unit and that sufficient working and office space is available for any proposed additional staff.
ii) I am prepared to have the program of activities, if funded under this application, carried out in my organisational unit under the circumstances set out by the Applicant as well as support their residency component within ITaLI.
iii) I have noted the amount of time that the Applicant will be devoting to the project and associated capacity-building activities and agree that it is appropriate to their workload. I agree that teaching relief will be arranged if the funding application is successful.
Head of School / School
Signature / Date
PART B: Faculty/School Statement of Support
The statement of support should endorse the nomination, with specific reference to the selection criteria. In addition, the statement may detail the direct and indirect support that the Faculty or School will provide during the Fellowship. This statement should be provided by the Faculty Associate Dean (Academic) or delegate in consultation with the relevant Head/s of School/s. (maximum one page)
PART C: Description of proposed Fellowship activities, outcomes, timeline and budget
The description must include:
- a discussion of the teaching and learning issue to be addressed
- a detailed explanation of the project’s contribution to one or more of the goals and/or initiatives outlined in the UQ Student Strategy White Paper
- an list of the course (or courses) to be converted to blended mode (if applicable) and an explanation of why this/these course/s is/are appropriate targets for revision
- a list of proposed deliverables from the project
- a plan of activities/approach to address the issue or course revision
- the strategy for collaboration and dissemination within the University
- the potential impact on student learning
- a Fellowship timeline that plots project milestones (for deliverable production and activities) and concurrent academic activities
- a project budget
(Maximum four pages)
PART D: Applicant’s capacity to conduct the project
The applicant can demonstrate their capacity to undertake the project with evidence of, for example:
- experience in managing projects
- capacity to innovate in university teaching
- strategic position and capacity to drive change within a course or suite of courses
- experience of successful transformation of courses to flipped or blended modes
- leadership in teaching and learning within their discipline, School or Faculty
- publishing in the scholarship of teaching and learning
(Maximum one page)
Email complete nomination form from Faculty Associate Deans (Academic) to: ITaLI
by 5:00pm on Friday 3 November 2017