Applicant: 			«Title» «Initials» «Surname»
Faculty/Department	«FacultyDepartment»
Office applied for:		«OfficeSought»

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Vice-Chancellor’s Senior Academic Promotions Committee

Please tick as appropriate:

The documentation made available to the Vice-Chancellor’s Committee was the same as submitted to the School Committee. 		

Documentation additional to that submitted to the School Committee was made available to the Vice-Chancellor’s Committee		

This was as follows:

(Please specify clearly below the nature of the documentation. e.g. references nominated by applicant/Faculty Committee; College statement; NHS statement, etc.

1.

2.

3.

Comments (if any)

Signed:_____________________________________ Date:_______________________

Secretary of Vice-Chancellor’s Senior Academic Promotions Committee