Use this form to propose a new External Examiner to the External Examiners’ Committee. This form should not be used to extend an appointment or change of duties for an External Examiner. The completed form should be returned to Secretariat and must carry College authorisation. Please complete all sections fully – quoting ‘see attached CV’ is not permitted. The External Examiner’s module responsibilities must be listed in section 4. If a section is not applicable write N/A. Additional relevant information may be attached as necessary. The Guidance Notes on the Appointment of External Examiners give further information particularly in relation to conflicts of interest. In the event of a change of post or institution a Change of Circumstances form MUST be completed - these are available through the Secretariat Blog or from Marina Fox, Officer to the External Examiners Committee. Please phone 01522 886690 or email . THIS FORM WILL BE RETURNED IF NOT ADEQUATELY COMPLETED.
1. Examiner Information
1.Full name and title of proposed examiner: / First Name(s): / Surname and title: Prof/Dr/Mr/Mrs/Ms/Other - (please specify):
2.Current post and work address:
Email: / Telephone:
3.Correspondence address if different:
Email: / Telephone:
4.Higher Education
(i) College(s)/University(s) attended:
(ii) Qualifications gained, with dates:
5.Relevant Employment
(i)Employer(s):
(ii)Post(s) with dates:
6.Relevant Professional Qualifications
(i)Professional Body:
(ii)Qualifications/status of membership, with dates:
7.Current External Examiner appointments (please give details):
(Include name of institution(s), course/ programme title(s), level and dates of appointment. The University of Lincoln does not normally make an appointment where this would lead to the Examiner having more than 2 substantial appointments concurrently).
8.Previous (recent) experience as an External Examiner (please give details):
(With name(s) of institution(s), course titles and level and dates of appointment)
9.Other relevant experience as Internal Examiner or in other capacity:
(Give names of institution(s) where appropriate, course titles, level and dates)
10.Research and related scholarly/ professional activity/consultancy:
(Briefly list main activities with particular reference to the last five years with dates. Cross-reference may be made to accompanying CV where details such as books, publications and articles in academic or professional journals are concerned).
11.Teaching or equivalent professional experience:
(Give brief outline of main areas of teaching or professional responsibilities (if any) over the last five years)
2. Programme Information
1.Details of the Subject/Programme:
(i)Subject Title (please specify name of subject/ programme)
Undergraduate Subject / Higher National Subject / Taught Postgraduate Subject
Foundation Degree / Other
(if other please specify eg non-tariff study)
(ii)Which subject benchmark applies (if any)?
2.Name of University School or Partner College responsible for Subject/ Programme:
(please list all delivery locations for the subject/programme, including overseas and indicate those for which this examiner will be responsible)
3.Module/Programme Responsibilities
Modules/programmes for which the proposed Examiner will have particular responsibility. Please state the number, size (ie credit points/student numbers) and level of modules as appropriate. / This section must be completed fully with Module Titles and Codes for all applications
Where relevant please indicate the stages and times of year at which the External Examiner will be involved (eg two cohorts per year, November and April.
School contact (subject/ programme co-ordinator/leader): / Name: / Position:
4.Module/Aspect Responsibilities Pro Forma
Please complete ALL columns
MODULE CODE / MODULE NAME / PROGRAMME/TITLE(S) TO WHICH THIS MODULE CONTRIBUTES / CREDIT POINTS / STUDENT NUMBERS5.Proposed Period of tenure
(normally four years) / From 1 October 20 to 30 September 20
3. External Examiner Team
1.Examiner to be replacedNew examiner should take up appointment on or before retirement of predecessor. / Name: / Place of work and position:
PLEASE NOTE:
Schools are advised that an examiner should not be succeeded by another from the same institution. / Appointed From:
1 October 20to 30 September 20
2.External Examiner Team
Where the proposed Examiner is one of a team for the subject/programme give details of other proposed/ approved Examiners indicating the relationship between them. Those not approved should be clearly marked*. / NAME / INSTITUTION
4. Conflicts of Interest
Identification of possible conflict of interest: Association with University/programme/individual staff/students*(i)Has the proposed examiner ever taught at the University or partner college? / YES / NO
(ii)If so, when did the commitment cease? / MONTH / YEAR
(iii) Has the proposed Examiner any other recent connection with the University including sitting on validation panels? / YES / NO
(iv)If yes, please give details:
(v)Does the Programme Leader act as External Examiner for a course in which the proposed external has an interest (eg by reciprocation)? / YES / NO
(vi) If yes, please give details:
(vii)Are any University of Lincoln academic staff known to be external examining similar awards at the nominee’s institution? / YES / NO
(viii)If yes, please give details:
* please refer to guidance notes
5. Authorisation
Nomination Proposer
Nominee proposed by (please print) / Name: / Position/title:
Confirmation of support by Head of School
Support of Head of School / Name: / Date:
Signature:
FOR USE BY COLLEGE BOARD (OR RELEVANT DELEGATED BODY)
College Board approval
Date of College Academic Affairs Committee
Chair of College AAC signature:
FOR USE BY EXTERNAL EXAMINERS’ COMMITTEE
Date of External Examiners’ Committee:
Decision of Committee: / APPROVED / NOT APPROVED (delete as applicable)
Chair’s Signature:
FOR USE BY SECRETARIAT
Date appointment letter issued:
Date eligibility to work documentation received:
Type of documentation received:
The University of Lincoln is registered as a Data Controller with the Office of the Information Commissioner. The information on this form will be disclosed to the College Academic Affairs Committee for agreement and to the External Examiners Committee for approval. Personal data is stored and processed securely by the University under the requirements of the Data Protection Act 1998. Unsuccessful applicants’ details will be securely destroyed within one year after submission to the External Examiners Committee.
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