RECORD OF PROBATION FOR NON-CLINICAL ACADEMIC STAFF 

This document will be strictly confidential to those involved in the assessment of the probation,
including Appointments Committees

Surname		Forename(s)		Title		

Faculty/Department		Date of Appointment		Term/Year		

CRITERIA (these should include any essential development activities identified by the Head of Institution after consultation with the probationer)	Satisfactory	Not Satisfactory	Comments 	
Teaching (including examining)

				
Research

				
General Contribution

				
Signature of Head of Department/Appraiser		Date		
Comments by Probationer

	
Signature		Date		

CONFIDENTIAL                                                                                                                        PD.PROB.R1

Please complete a sheet for each year/term of probation with any additional comments and/or supporting 
statements attached