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Department Contact: Phone: Date: To: From: Department: Choose One AASP - Asian American Studies ANTH - Anthropology ARTH - History of Art and Architecture ARTS - Art BENG - Bioengineering BLST - Black Studies BMSE - Biomolecular Science and Engineering CCSP - Counseling, Clinical, and School Psychology CFTM - Carsey-Wolf Center CHEM - Chemistry and Biochemistry CHNE - Chemical Engineering CHST - Chicana and Chicano Studies CLAS - Classics CMST - Communication COMS - Computer Science CRST - College of Creative Studies DRAM - Theater and Dance EAPQ - UC Education Abroad Program EAST - East Asian Languages and Cultural Studies ECON - Economics EDUC - Education EEMB - Ecology, Evolution and Marine Biology ELEG - Electrical and Computer Engineering ENGL - English ENGR - Engineering ENMT - Materials ENST - Environmental Studies Program ESMS - Bren School of Environmental Science and Management FILM - Film and Media Studies FRIT - French and Italian GEOG - Geography GEOL - Earth Science GERM - Germanic and Slavic Studies GISP - Global Studies GSED - Graduate School of Education GSER - Gevirtz Graduate School of Education - Research HIST - History HMCT - Humanities Center IHUC - Interdisciplinary Humanities Center INEE - Institute of Energy Efficiency INST - Instructional Development LAWS - Law and Society Program LING - Linguistics LSAA - Letters & Science - Academic Advising MATH - Mathematics MATP - Media Arts and Technology MCDB - Molecular, Cellular and Developmental Biology MECE - Mechanical Engineering MTRL - Materials Research Lab MUSC - Music PHIL - Philosophy PHYA - Exercise and Sport Studies PHYS - Physics PLYI - Center for Polymers and Organic Solids POLS - Political Science PSYC - Psychological and Brain Sciences RELG - Religious Studies SAPP - Statistics and Applied Probability SOCL - Sociology SOSC - Social Sciences SPAN - Spanish and Portuguese SPCH - Speech and Hearing Sciences SSLE - Solid State Lighting and Energy Center SUMS - Summer Session Office TECH - Technology Management TEP - Teacher Education Program UGED - Office of Undergraduate Education WRIT - Writing Program WSTD - Feminist Studies Re: Lecturer and Supervisor of Teacher Education Choose One Initial Appointment 2-Year Reappointment 3-Year Reappointment Supplemental Assignment Is this a modification of an already-approved appointment or reappointment term? Yes No
Appointee: Employee ID: Reports to: Reports To Position #: Worksite ID: Choose One 8-162 (AASP - Asian American Studies) 8-218 (AFFA- Title IX Office) 8-114 (ANTH - Anthropology) 8-126 (ARTS - Arts Admin Support Center) 8-93 (ASTD - Associated Students) 8-102 (ATHL - Athletics) 91 (BFS) 8-133 (CARE - Career Services) 8-217 (CFTM - Carsey-Wolf Center) 8-94 (CHEM - Chemistry) 8-92 (CHLD - Childcare) 8-219 (CHNE-Chemical Engineering) 8-134 (CITO - ENTERPRISE TECHNOLOGY SERVICES) 8-136 (COMM - Communications) 8-175 (COMS - Computer Science) 8-210 (CONF - CONFERENCE) 8-130 (COUN - Counseling/CAPS) 8-135 (CRST - Creative Studies) 8-104 (CTRL - Controller) 8-109 (DEVL - Development) 8-105 (DFSS - Facilities) 8-128 (DOST - Student Life Cluster) 8-145 (DRAM - Dramatic Arts / Dance) 8-211 (DSRS - RESIDENTIAL & COMMUNITY LIVING) 8-116 (EAPQ - UC Education Abroad Program) 8-119 (ECON - Economics) 8-113 (EDUC - Gervirtz Graduate School of Education) 8-97 (EEMB - Ecology, Evolution & Marine Biology) 8-112 (ELEG - Electrical & Computer Engineering) 8-100 (ENGR - Engineering) 8-190 (ENMT - Materials) 8-152 (ENST - ENVIRONMENTAL STUDIES) 8-122 (EOPO - Educational Opportunity Program) 8-155 (ERII- Earth Science) 8-132 (ESMS - Bren Graduate School) 8-150 (FARM - Financial and Resource Management) 8-206 (FCHO - THE CLUB) 8-213 (FDCN - Concessions) 8-203 (FDFT - PORTOLA DINING COMMONS) 8-214 (FDRR- Tenaya Market) 8-204 (FDSC - CARRILLO DINING COMMONS) 8-201 (FDSD - DE LA GUERRA DINING COMMONS) 8-215 (FDSE- Catering) 8-202 (FDSO - ORTEGA DINING COMMONS) 8-200 (FDSR - CENTRAL DINING) 8-96 (FILM - Film Studies) 8-121 (GEOG - Geography) 8-120 (GISP - Global Studies) 8-138 (GRAD - Graduate Division) 8-207 (HDAE CENTRAL) 8-124 (HSSB - HSSB Administrative Support Center) 8-180 (ICBT - Institute for Collaborative Biotechnologies) 8-142 (IHUC - Interdisciplinary Humanities Center) 8-140 (INEE - Institute for Energy Efficiency) 8-123 (INST - Institutional Advancement) 8-216 (ISBE - Inst. Social Behaviour Econ Research) 8-185 (ISBE - Institute for Social, Behavioral and Economic Research) 8-165 (KITP - Kavli Institute for Theoretical Physics) 8-107 (LIBR - Library) 8-118 (LSAA - Letters and Science) 8-101 (LSIT - College of Letters & Science) 8-131 (MATH - Mathmatics) 8-172 (MATP - MEDIA ARTS & TECHNOLOGY PROGRM) 8-157 (MCDB - MOLECULAR BIOLOGY) 8-137 (MECE - Mechanical Engineering) 8-98 (MSII - Marine Science) 8-115 (NCEA - National Center for Ecological Analysis and Synthesis) 8-212 (OPERATIONS/TPS) 8-170 (PERS - Human Resources) 8-127 (PHYS - Physics) 8-103 (POLI - Police Dept) 8-129 (POLS - Political Science) 8-117 (PSYC - Psychological and Brain Sciences) 8-99 (REGR/FINA - Financial Aid) 8-110 (SASC - South Hall) 8-111 (SASC - South Hall - Students) 8-160 (SASS - Student Academic Support Services) 8-108 (STHL - Student Health) 8-106 (STSP - Disabled Students Program) 8-139 (SUMS - Summer Sessions) 8-220 (TECH) 8-209 (UCBS - CAMPUS STORE) 8-208 (UCEN & DLSS - University Center) 8-205 (UCFS - RETAIL DINING) 8-125 (WC - Wellness Cluster) Title: Lecturer (1630) Lecturer (1632) Senior Lecturer (1640) Senior Lecturer (1642) Supplemental Assignment (1648) Supplemental Assignment-1/9th (1649) Supervisor of Teacher Education (2220) Pay basis: 9/9 9/12
If employed at another campus, an MLA form is needed. Please also provide details below.
If you prefer, please attach a copy of your qualifications and experience with the form.
If any courses are graduate-level, please attach the approved Request for the approval of graduate instructions form.
Has a Pre-Six Assessment been conducted? Yes No Per RB II-3, a Pre-Six Assessment must be conducted as part of consideration for a 2-year reappointment. Please submit:
Has a Pre-Six Academic Review been conducted? Yes No Per RB II-4, a Pre-Six Academic Review must be conducted as part of consideration for a 3-year reappointment. Please submit:
Department Chair Signature
Date
Dean Signature
(Last Revised 12/2023)