Reviewer Nomination Form

Lakehead University

Cyclical Program Review: External Reviewer Nomination Form

All cyclical program reviews include a site visit with a review team comprised of both external and internal reviewers. There will be at least one external reviewer selected to participate in undergraduate program reviews, and at least two external reviewers selected to participate in graduate program reviews or in a concurrent review of both undergraduate and graduate programs.

The reviewers will normally be associate or full professors, or the equivalent, will be qualified by discipline and experience to review the programs, and will be at arm’s length from the program under review. External reviewers should be active and respected in their field.

Additional discretionary members may be assigned to the review team where deemed appropriate and necessary. Such additional members might include relevant qualified and experienced people selected from industry or the professions, and/or student members. Decisions to add members to the review team will be made by the Deputy Provost based on consultation with the Dean(s).

Date:
Name of Program Review Coordinator:
Faculty:
Department/ School:
Program being reviewed:

Declaration of any previous affiliation with the proposed program, home unit, and faculty members

All members of the Review Committee must be at arm’s length from the unit/program(s) under review. This means that reviewers and consultants cannot be current or recent collaborators, former supervisors, advisors or colleagues of members of the unit/program. Arm’s length does not mean that the reviewer must never have met or even heard of a member of the program. It does mean that reviewers should not be chosen who are likely, or perceived to be likely, to be predisposed to view the program or unit eitherpositively or negatively.

Examples of what may violate the arm’s length requirement:

• A previous member of the program or department under review (including being a visiting professor)

• Received a graduate degree from the program under review

• A regular co-author and research collaborator with a member of the program, within the past seven years,

and especially if that collaboration is ongoing

• Close friend or family relationship with a member of the program

• A regular or repeated external examiner of dissertations by doctoral students in the program

• The doctoral supervisor of one or more members of the program

I, the coordinator for this Cyclical Program Review, warrant the truthfulness of the information provided in this External Reviewer Nomination Form.

Electronic Signature (please type your first and last name):

I understand that checking this box constitutes a legal signature confirming that I acknowledge and

agree to the Declaration above

Using the templates contained on the following pages, please nominate at least six (6) External Reviewers.

Name of External Nominee #1

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer

Name of External Nominee #2

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer

Name of External Nominee #3

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer

Name of External Nominee #4

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer

Name of External Nominee #5

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer

Name of External Nominee #6

Educational Credentials

Degree:
Institution:
Year:

Current Positions (e.g Associate Professor, Professor, Dean, etc.)

Current Department/Faculty

Current Home Institution

Contact Information

Email:
Phone: ( ) -

Current Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Previous Administrative Responsibilities and/or Relevant Experience

Title:
Program:
Date:
Title:
Program:
Date:

Brief Biography (CV, Website, Research Interests)

Brief Statement concerning his/her appropriateness as a reviewer