Name of nominee: Date: Department/school: E-mail address of nominee Semester/term and year of approval: Profile of the candidate:
A. Date appointed to EIU Faculty: B. Current academic rank: C. Academic and professional experience: Highest degree earned: Date awarded: Does the nominee have the appropriate terminal degree? Yes No Degree granting institution: Field of specialization: D. Evidence of professional activity and specialization in teaching area (if different from the academic area in which the highest earned degree is held) within the last three years (workshops, research, service, creative activity, etc.). Please put in vita format and attach. E. List the graduate courses taught by the candidate during the last three years:
__________________________________________ Graduate Coordinator or Chair, Department Graduate Committee
___________________________________________ Department Chair
_________________________________________ College Dean
___________________________________________ Dean, Graduate School