ࡱ> \^[O Objbjhh .Vee   MM81T(t"I) l 89';';';';';';'$)8,_'i ^'" _'MM'%%% vMl9'% 9'%%,%@*$3C!%%''0(%,C!,%%&,%L % _'_'# ( ,  :  SHAPE \* MERGEFORMAT   FORMCHECKBOX  Request for a new position  FORMCHECKBOX  Request to fill a vacated position  FORMCHECKBOX  Request to fill a vacated position with a direct replacement Institute:  FORMTEXT      Department: Rank of Position: PCN: Term (Y or N):Fund Source:  FORMTEXT      Discipline: Anticipated CIP: Proposed Salary Range*: Direct Hire (Y or N):  SECTION 1: REQUEST TO FILL A VACATED POSITION If this request is to fill a vacated position, please complete the following: Name of the faculty member whose position will be vacated:  FORMTEXT       Reason for leaving:  FORMTEXT       Note: Please provide the Provost s Office with copies of resignation, retirement, termination, and non-retention notices. The information supplied by the department chair will be weighed by the dean in deciding and recommending to the Provost the disposition of open lines. What specific needs will the incumbents departure create? What departmental and/or program priorities were met by the incumbent? What other options are there for covering these courses? To what extent is this position critical to maintain sufficient faculty numbers to sustain your program? How critical is the incumbents teaching, research, and/or service specialty to the programs ability to offer required courses and maintain the integrity of the program? How does this persons area of scholarship align with campus priorities (e.g., the Strategic Plan, etc)? SECTION 1a: DIRECT REPLACEMENT If this is a request for the direct replacement for a vacated position, please complete the following section. Note: A justification memo addressed to the Provost and Executive Vice Chancellor must be included with the Job Request Form. You may attach a memo to this DocuSign JRF. What is the importance for a direct placement for your graduate program? If applicable: How would you compensate for any unfulfilled responsibilities that would result from not replacing the incumbent directly? Other comments: SECTION 2: REQUEST FOR A NEW POSITION (You may attach a memo to this DocuSign JRF- if applicable). If this is a request for a new position, please complete the following section: What is the rationale for creating the new position? Please be specific: How would you seek to use this position in the development of the program and/or department? How would the new position align with campus priorities (e.g., the Strategic Plan, etc)? Comments: SECTION 3: ADDITIONAL QUESTION Response Required Recruitment Committees are required to attend the Diversity and Implicit Bias Training provided by the UAHR Team. In addition to the mandatory UAHR Diversity and Implicit Bias Training, what will be your search committee s strategy for ensuring a diverse and inclusive faculty peer group that includes this hire? Other comments: Signatures  FORMTEXT        FORMTEXT       _________________________________ _____________________ Research Director Date Comments: _________________________________ _______________________ Vice Chancellor for Research Date Comments:  FORMTEXT        FORMTEXT       _________________________________ ______________________ Provost and Executive Vice Chancellor Date Comments: Once all signatures have been collected, this form will be routed back to the research directors office.     WORKING DRAFT: TO BE USED AS A WORKING DRAFT DO NOT SUBMIT TO BE PROCESSED OR SIGNED. 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