DOCUMENT 10 (CRS)

Employee name

Contribution Reward Scheme for Senior Lecturers

Proposal for Contribution Increment(s)

A proposal should be made by the individual concerned by completing Part 1 of the form.  

Once completed the form should be submitted to the relevant FPC Secretary. 

Part 1: To be completed by applicant

Contribution Increments are awarded to recognise a senior lecturer’s outstanding and sustained excellence in teaching, and outstanding and sustained general and/or administrative contributions over and above the normal expectation for the role for a period of not less than 1 year, with the expectation of continued working at that level. 
If you wish to be considered please complete Part 1 of this form, setting out the reasons for your application and providing evidence of your personal contribution to teaching and general/administrative contributions over and above the level expected of a person performing competently as a senior lecturer, in support of the academic objectives of your Institution. Please submit your completed application to the relevant FPC Secretary.

I wish to be considered for (please tick):		One Contribution Increment   
Two Contribution Increments 

I confirm that I meet the eligibility criteria set out below: 

•	I am a senior lecturer
•	I have reached the maximum service point for my grade (Grade 10, point 61) as at 1 October 2016
•	I have been in my post and performing my duties at my current grade and on point 61 for at least one year prior to 1 October 2017

Please set out in full overleaf (or on an attached sheet) the reasons for your application and, where appropriate, explain why more than one increment is requested.   You should refer to the teaching and general contribution criteria for University Senior Lectureship detailed in 5.15, 5.16 and 5.17 of the Senior Academic Promotions guidance when setting out your case, giving quantitative evidence, including dates, where possible, as well as setting out the added value of your achievements and details of sustained leadership.

Teaching  
Evidence of outstanding and sustained excellence in teaching:

	

General Contribution
Evidence of outstanding and sustained general and/or administrative contributions including leadership:

	

To assist the Faculty Promotions Committee: 

Suggestion for internal referee to comment on your case:

Name …………………………………………………………….

Please note that the decision on who to contact for a reference rests with the Faculty Promotions Committee.

Signature (applicant)			
Date		
Full name 		
Job Title		
Institution		

Proposal for Contribution Increment(s)

Part 2: To be completed by the Head of Institution/Other delegated senior academic officer

Contribution Increments are awarded to recognise an individual's sustained and outstanding contribution in teaching and general/administrative areas over and above the normal expectation for the role for a period of not less than 1 year with the expectation of continued contribution at that level. Please read the guidance and criteria for Contribution Increments in Section 13 of the Senior Academic Promotions guidance before completing this form. 

Reports listing details of all eligible staff have been sent to nominated report recipients for Institutions via the secure burst reports mechanism.  

Institution		
Full name of staff member		
Job title of staff member		
Current salary scale point as at 1 October 2017		
Date appointed to present post		
Number of contribution increments proposed 	One            Two         	
Priority order		

Please comment on the applicant’s achievement of the criteria (13.16 of the guidance) as set out in Part 1 of the form, and whether you support their case for an award.  

Where appropriate, please explain why more than one increment is proposed (continue on a separate sheet if necessary).

Teaching  
Evidence of outstanding and sustained excellence in teaching:

	

General Contribution
Evidence of outstanding and sustained general and/or administrative contributions, including leadership:

	

General Summary of case for outstanding performance 

	

Comments of Head of Institution/delegated senior academic officer where the case is not supported 

Signature 			
Date		
Full name/ Position