Step 1: Applicant Details

STEP 1: APPLICANT DETAILS

Staff ID:
Surname: / Name: / Title:
Faculty:
School / Centre:
Phone 1: / Email:
Phone 2:

STEP 2: APPLICATION SUMMARY

Current Position:
Position Type: / Choose an item.
Contract term: / Choose an item. / If fixed-term, contract end date:
Promotion Level Applied for: / Choose an item.
Promotion Track Selected:
Select the promotion track you wish to apply for. Select one option only in your staff category.
For Teaching and Research staff only: / For Research Only staff only:
Choose an item. / Choose an item.

Special Consideration:

Applicants are encouraged to ensure that they clearly specify any relevant circumstances that may have adversely affected them in relation to the promotion criteria. Place an ‘X’ beside the option that applies to you:
I am not seeking special consideration.
I am seeking special consideration and have included the relevant documentation in my application.

STEP 3: EMPLOYMENT SUMMARY

Provide details of your employment history below in reverse chronological order, listing your most recent employment history first. Usually applicants should have completed two years of service since their appointment at UNSW, or their most recent promotion, before they become eligible for promotion. The Faculty Dean may apply to the Deputy Vice-Chancellor (Academic) for this two year requirement to be waived.

Summary

1. / Date of appointment to UNSW:
2. / Date of last promotion at UNSW:

Employment History

Delete or add sections as necessary

1.
Employer: / From:
Position: / To:
2.
Employer: / From:
Position: / To:
3.
Employer: / From:
Position: / To:
4.
Employer: / From:
Position: / To:
5.
Employer: / From:
Position: / To:
6.
Employer: / From:
Position: / To:

STEP 4: QUALIFICATIONS, AWARDS AND MEMBERSHIPS

Awards would include those awards which are relevant to your area of research or discipline. Examples may include School , Faculty, University or Community awards or Fellowships. Memberships may include such things as memberships of Professional Bodies , Academic Societies or Community Bodies.

Academic Qualifications:

Delete or add sections as necessary

1.
Institution: / Date awarded:
Qualification:
2.
Institution: / Date awarded:
Qualification:
3.
Institution: / Date awarded:
Qualification:
4.
Institution: / Date awarded:
Qualification:

Awards, Fellowships and Memberships:

Delete or add rows as necessary

Title/Name: / Date awarded:
1.
2.
3.
4.

STEP 5: REFEREES NOMINATED APPLICANT

Provide the details of all referees in the fields below. Applicants should discuss with their Head of School the referees they propose to nominate. Applicants should seek the concurrence of referees before confirming their nominations and should provide referees with a copy of their application. The Head of School, Dean or anyone directly involved in the assessment process may not be nominated as a referee.

STEP 6: REFEREES NOMINATED BY HEAD OF SCHOOL

Provide the details of referees nominated by the Head of School in all fields below. The Head of School will prepare for the Dean's consideration a panel of suitable referees. The Head of School should contact potential independent referees prior to the submission of a panel list to the Dean so as to ascertain as to whether those on the list are prepared to act as an independent referee if contacted by the university. The applicant should have the right to comment on the suitability of the referees that have been provided to the Dean by the Head of School.

Referee 1:
Name:
Title:
Organisation:
Phone: / Email:
List the area/s of recent work and/or performance with which the referee is familiar below:
Referee 2:
Name:
Title:
Organisation:
Phone: / Email:
List the area/s of recent work and/or performance with which the referee is familiar below:
Referee 3:
Name:
Title:
Organisation:
Phone: / Email:
List the area/s of recent work and/or performance with which the referee is familiar below:
Referee 4: - For promotion to Professor and Associate Professor only
Name:
Title:
Organisation:
Phone: / Email:
List the area/s of recent work and/or performance with which the referee is familiar below:
Referee 5: - For promotion to Professor only
Name:
Title:
Organisation:
Phone: / Email:
List the area/s of recent work and/or performance with which the referee is familiar below:

STEP 7: OBSERVER AT INTERVIEW

If you wish to nominate an observer to attend your interview please provide the details below. Your nominated observer must be a staff member of UNSW. A nominated referee is not permitted to act as an observer.

Name:
Title:
Organisation:
Phone: / Email:

STEP 8: ACCOUNT CODES

Your application will be printed by Print3 Printing Services. Please provide the account codes against which this cost is to be charged. Account codes can be obtained from your School Manager.

Account / Fund Code / Dept ID / Project/ Grant / Budget period

STEP 9: SIGNATURES

Applicant: / Signature: / Date:
To the best of my knowledge, the applicant has adhered to what we value as a University as defined in the 'UNSW Blueprint to Beyond: Strategic Intent'.
Head of School: / Signature: / Date:
To the best of my knowledge, the applicant has adhered to what we value as a University as defined in the 'UNSW Blueprint to Beyond: Strategic Intent'.
Dean: / Signature: / Date:

Application for Promotion – Form A