Faculty Roster Form
Qualifications of Full-Time and Part-Time Faculty
See Faculty Course Roster Template Instructions for more information on how to complete the Course Roster.
Name of Institution:
Name of Primary Department, Academic Program, or Discipline:
Group by discipline. Independent Studies courses should be listed on a separate course roster apart from regular courses.
Academic Term(s) Included: Date Form Completed:
1 / 2 / 3 / 4 /NAME (F, P) / COURSES TAUGHT
Including Term, Course Number & Title, Credit Hours (D, UN, UT, G) / ACADEMIC DEGREES& COURSEWORK
Relevant to Courses Taught, Including Institution & Major
List specific graduate coursework, if needed / OTHER QUALIFICATIONS & COMMENTS
Related to Courses Taught /
Provide the name of the instructor and indicate full (F) or part-time (P) status.
Anyone who teaches a course must be listed, including Associate Deans and staff.
This information can be found on the Certification of Credentials Form, Part I - Candidate Name and Classification. / List from the Bulletin the course prefix, course number, and course title of all credit courses taught.
Indicate whether it is undergraduate transferable (UT) or graduate (G).
This information can be found on the Certification of Credentials Form, Part III – Course Number & Title. / List the earned academic degrees, diplomas and certificates. List only what is needed to justify qualifications to teach the listed courses.
Indicate the discipline and awarding institution
List specific graduate coursework, if needed
Degrees/coursework must have an official transcript. Foreign degrees must have a foreign credential certification
This information can be found on the Certification of Credentials Form, Part III – Academic Degrees & Coursework Relevant to Course / Only list what is needed to justify qualifications to teach a specific course
Indicate the dates for additional qualifications
Clearly describe the relationship between these qualifications and the course content and/or expected outcomes.
Work done at UNCSA cannot be used
Must have substantiating documentation on file
This information can be found on the Certification of Credentials Form, Part III – Experiential Qualifications Related to Course and Competency Analysis of Experiential Qualifications
F, P: Full-time or Part-time; D, UN, UT, G: Developmental, Undergraduate Nontransferable, Undergraduate Transferable, Graduate
Form Updated: January 2011