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: / (indicate Research Focussed / Education Focussed / Research & Teaching)
Contract term: / (indicate whether Continuing or Fixed-Term)
If Fixed-Term, contract end date:
Promotion Level Applied for:

STEP 3: APPLICANT ACHIEVEMENTS AND CONTRIBUTIONS

Applicants are asked to clearly outline in both their Executive Summary Page and in the main body of their application what they consider to be their achievements and contributions in each of up to three pillars of academic performance (Research, Education and Social Engagement, Global Impact & Leadership) and may, if they wish, indicate the level of their performance (Outstanding, Superior or Current).

Relative to Opportunity Performance Evaluation:

The University is committed to the principlesof Relative to Opportunity Performance Evaluation (ROPE).

Applicants are invited to outline any circumstances that are relevant to their case for promotion so that the promotion committees can take these circumstances into account when assessing an application.

Please indicate by ticking the box below if you are reporting circumstances relevant to ROPE in your case for promotion.

In such cases applicants are asked to include up to one extra page, summarising the relevant circumstances and the impact of such circumstances as an appendix to their 10page case for promotionin their case for promotion.

In cases where a higher level of confidentiality is desired, applicants are asked to discuss their personal circumstances in confidence with either their Head of School or the Academic Promotions Manager so that appropriate steps can be taken.

Consideration needs to be taken in the context of the principles to relative to opportunity performance evaluation.

STEP 4: EMPLOYMENT SUMMARY

Provide details of your employment history below in reverse chronological order, listing your most recent employment history first.

Summary

Date of appointment to UNSW:
Date of last promotion at UNSW:

Employment History

Delete or add sections as necessary

Employer / Position / Start and Finish Dates

STEP 5: 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 Communityawards or Fellowships. Memberships may include such things as memberships of Professional Bodies, Academic Societies or Community Bodies.

Academic Qualifications:

Institution / Qualification / Date Awarded:

Awards, Fellowships and Memberships:

Delete or add rows as necessary

Title/Name: / Date awarded:

STEP 6: 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. Applicantsshould 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.

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: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: 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 ofsuitable 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 towhether 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 thesuitability 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 8: 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 beobtained 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 the University’s Code of Conduct and guiding principles.
Head of School: / Signature: / Date:
To the best of my knowledge, the applicant has adhered to the University’s Code of conduct and guiding principles.
Dean: / Signature: / Date:

Application for Promotion – Form A1