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Revised 7/2015 A2: Request for Promotion SSubrrit this form plus D-RE, letier of hice, and ASL-DES confirmation of ASLPI score to the Tenure & Promotion Committee by March 1*. | Section I: Background Information Date of Request: 02/01/2019 Name: Last: Takayama First. Kota | Department: Social Work Current Rank: Instuctor ‘School: SEBHS Requested Rank: Assistant Professor Effective Date for promotion: Oa/6207 Date of rital Appointment Is there @ contractual agreement fr early promation totenurestrack status: 08/16/2014 consideration? C) YES @) NO (click one) Date of appointment to present rank oanei2014 YES, attach supparting documentation Section Il: Academic Qualifications Highest degree Discipline: Section Ill: Summary of Ratings and Points (from Form D-RE) ‘Areas of Evaluation Rating (circle) Points ‘Teaching 0 3 2. Scholarship/Creativity ActivityResearch c@o 3 3. Service. c@o 3 4. ASLPI Dal ‘ASLPI Rating’ NA 5. SCPI Date ‘SCPI Rating": NA 5. Professional Integrity © Us NA Total Points >> 3 ‘You must have at least six points to qualify for promotion, 0 Outstanding is 3 points C Commendable is 2 points S Satisfactory is 1 point Promotion cannot be granted if there are any U Unsatisfactory ratings. “Targeted ASLPI rating of 3 or SCPI rating of Intermediate Plus is required. Ifthe rating is below the targeted score, please provide documentation of effors to improve ASL. Section IV: Department Chair's Certification “The procedures and ceria sipulaed in the Universy Facully Guidelines and inthe Department Faculy Evaluation Salar ee beset aaa D+1-20/9 : “Dean i promalion Tor he Cha Department Chair* Section V: Tenure & Promotion Committee (to be completed by 2 member of Tenure & Certification Promotion Committee only) In accordance to the UF Guidelines, this facultymember (ISIS NOT (click) eligible for the requested promotion. Ifnot, explain the nature of conflict Tenure & Promotion Commities Member Dale Section VI: Administrative Approval Approved C) NotAproved CQ) | DEB Date