Temporary Graduate Faculty Request

Temporary Graduate Faculty Request
Instructions: Complete all items. Submit to your department chair for review and approval.
Attach a curriculum vitae, if not submitted within the last two years.
Please attach your Curriculum Vitae:*

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Your Name:*

First NameMiddle NameLast Name
Department:*
Highest Degree Earned: *
Year Earned:*
Discipline of Highest Degree:*
Your Email:*
List all graduate classes to be taught:
Are you a current employee at ETSU?

YesNo
If serving on their committee, please include student's name:
Department Chair's email:*
example@etsu.edu
Appointee's Signature:*

Clear
Application Status:*

ApproveDeny
If applicant does not hold terminal degree in the field, explain qualifications for appointment
If serving on a student committee, indicate the student’s program (e.g., PhD Biomedical Sciences) and the member’s contribution to the project. If teaching a course, briefly indicate need for hiring an adjunct for graduate course and the person’s qualifications for the course(s) listed.*
I certify that this individual is qualified for the instructional assignment(s) listed above:
Department Chair Signature:*

Clear
Application Status:*

ApproveDeny
Reason:
Dean, Graduate School Signature:*

Clear
New ApplicationRe-Application
Current Level
Term Expires
E-number:*
Should be Empty: