Kingdom of Saudi Arabia

Majma'a University
ACADEMIC COUNCIL

APPLICATION FORM
FOR PROMOTION OF FACULTY MEMBERS
__________________________:Department of
______________________________:College of

PART ONE
(Resume (Curriculum Vitae
First

Father

Grandfather

____________ :_______________

Family

_____________

Name

___________

__________________________: Nationality
:For those on contract with University
Contract Date:
[

Hijra

:Personal

Employed in another country?

[
[

Gregorian

]Other Contract Type

] Yes

] No

:If yes, Name the Employer__________________________________________

:Current Academic Rank ____________________________________________
Date of Promotion to or Appointment in Current Academic Rank:
Day

Month

Year

_________

__________

__________

_________

__________

__________ Gregorian

Hijra

Applying for Rank of:

Associate Professor:
[ ]
Professor:
[ ]
Did you apply for this rank before
[ ] Yes
[ ] No
If yes, how many times did you apply for this rank?

Information on previous times: (if any)

Number of Academic Council Meeting: ________________________________
Academic Year: _______________________________ Date: / /
Hijra
Number of Academic Council Meeting: ________________________________
Academic Year:_______________________________ Date:

Hijra

Applicants Academic Degrees:

B.A./B.Sc.
University:____________________________
College:_______________

University Location ( City / State /

Country ):_______________________

Date of Obtaining Degree:

/
/
Hijra
Gregorian

Major: ________________________

M.A./M.Sc.:
University:____________________________
College:_______________

University Location ( City / State /

Country ):_______________________
Date of Obtaining Degree:
/
/
Hijra
/ /

Master s Study Method: Courses [ ]

Thesis
Both [ ]

Title of Masters Thesis(if any):

__________________________________

Advisor s Name:
_____________________________________________

Major:_________________________ Minor:
______________________

Gregorian
[ ]

Ph.D.or ( Fellowship ):
University:____________________________
College:_______________

University Location ( City / State / Country ):

______________________
Date of Obtaining Degree:
/
/
Hijra
/ /

Title of Ph.D.
Dissertation:_____________________________________

Advisor's Name:
_____________________________________________

Major:_________________________ Minor:
______________________

Gregorian

PART TWO
PESEARCH WORK
Research Work Submitted for Promotion:
A) Papers Published in Academic, Specialized, and Refereed Journals:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ _____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

B) Papers Accepted for Publication in Academic, Specialized, and Refereed

Journals:

_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

C) Papers Submitted to Academic and Specialized Conferences Which

Have Been Refereed and Published in Full in the Conference Proceedings
[Only one unit is accepted]:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

D) Papers Which Have Been Refereed and Published or Accepted for

Publication by Universities Research Centers [Only one unit is accepted]:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

E) Refereed Books Which Include Textbooks, Scientific References,

Edited Classical Books, and Translated Books [Only one unit is
accepted]:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

F) Patents:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

G) Creative Works [Only one unit is accepted]:

_ ____________________________________________________________________
_ ____________________________________________________________________
4

_ ____________________________________________________________________
_ ____________________________________________________________________

[ ]

No papers extracted from any scientific works are included in the research

work submitted for promotion.

PART THREE
Research Work Not Submitted for Consideration for Promotion
Only to be mentioned without enclosing:
A) Papers Published Prior to Obtaining the Ph. D ( if any):
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

B) Papers Extracted from Master's or Ph.D. Theses or any scientific

works (if any):
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

C) Other Unrefereed Works:

_ ____________________________________________________________________
_ ____________________________________________________________________

_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

D) Papers Published While Working as Assistant Professor: (for those

applying for promotion to Full Professor rank):
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

PART FOUR
Employment and Administrative History . (Dates should be specified by:
D/M/Y)

1) Employment History (in Descending Order - Last Given First):

_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

2) Administrative Assignments (in Descending Order):

_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

3) Scholarships and Awards (if any):

_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

PART FIVE
Participation in Conferences, Symposia Other Activities:
1) Participation in conferences and symposia other than those mentioned in
PART TWO/B. Please give names, dates, places, and your mode of participation
in them:
A) Conferences:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

B) Symposia:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

2) Other Activities:
A) Membership of Scientific Associations:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

B) Committees:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

C) Councils:
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________
_ ____________________________________________________________________

D) University and Community Service:

1) University Service:
_ ______________________________________________________________
_ ______________________________________________________________

_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________

2) Community Service:
_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________
_ ______________________________________________________________

PART SIX
TEACHING LOAD
Teaching load for the last four academic years including the semester in which
the faculty member is applying for promotion: (Information on teaching load
and others should be checked by the Department Chairman, Summer Term is
excluded).

Semester: ..

Academic Year:

Course

Hijra
Cr. Hrs.

( Please enclose)

Applicant's average of teaching Load for the last four academic years (eight
semesters): .

 Average of teaching load for the department's members for the semester in
which the faculty member is applying for promotion:

Name of Applicant:____________________________
Signature of Applicant:_________________________
Contact telephone:_____________________________
Date:

Hijra -

PART SEVEN
For official Use Only

Gregorian