Staff - Academic Status & Supervisor Application Form

Name *

Title First Name Middle Name Last Name Postnominals

Email *

example@example.com

Phone number *

Affiliated College *

UCLT - Higher Ed UCLT - VET Dayspring - Higher Ed SCMOI - Higher Ed CEDAL - VET ALC - VET

Qualifications *

	Award Name in Full	Awarding Institution Name	Year Awarded	Award Abbrev
Award 1
Award 2
Award 3
Award 4
Award 5

You are required to attach:

A copy of your current CV
Copies of your transcripts for eadch of the above named awards.

This is mandatory as the ACD is required to hold evidence of Academic staff qualifications under the Higher Education Standards Framework 2015.

Transcripts *

Browse Files

CV *

Browse Files

I am applying for *

Lecturer Accreditation Supervisor Accreditation Both

Lecturer Accreditation Section

I am applying to teach the following *

	Unit Code	Unit Name	Discipline	AQF Level
Unit 1
Unit 2
Unit 3
Unit 4

Basis of Application *

I hold a qualification one AQF level above the highest AQF level for which I am applying for Academic Status. I do not hold a qualification one AQF level above the highest AQF level for which I am applying for Academic Status and am applying on the basis of academic qualification AND professional equivalency.

Describe how your academic qualification and experience meet the criteria of the Academic Status you are applying for. *

Supervisor Accreditation Section

Outline the details of your teaching / supervision experience. If you do not hold an AQF level 10 qualification please make a case for why it is appropriate for you to be a supervisor. *

Describe your areas of research specialisation(s). *

List all of your publications for the last 5 years, specifically highlighting any that directly support the area of supervision for this application. *

Please give details of previous higher degree by research students you have supervised over the last 5 years. *

	Student Name	Award	Institution	Year(s)
Student 1
Student 2
Student 3
Student 4
Student 5
Student 6

Outline the details of any other research achievements, research grants, research fellowships, editorial board experience or learning academy memberships *

I confirm that I have read and agree to abide by the:

I have attached the required evidence for this application or I am an existing staff member and have previously supplied the evidence.

I confirm that all details of teaching and learning, publication and other service, which have been included in my application are accurate.

Signature *

Date

Recommendation by Affiliated College

Recommendation of Approval by Principal of College. *

I confirm that to the best of my knowledge the details in this application are accurate. I confirm that I have read the applicants CV I recommend the approval for the applied status I DO NOT recommend the approval for the applied status Additional Comments

Additional Comments *

Principal's Signature *

Date

Academic Status & Supervision Application Form