CON Summer Salary Award Report

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UNIVERSITY OF NEBRASKA MEDICAL CENTER
COLLEGE OF NURSING
Summer Salary Award Report Subsection: Appendix F2
Section - Appendices Originating Date: December 2007
Responsible Reviewing Agency:
Executive Council
Revised: January 2008
Revised: March 2015
Related documents:
 


Form

Submit 1 copy to Division Assistant Dean by 5 p.m. Friday Sept. 5 for signature.

Submit 1 copy, signed or forwarded on email by the Division Assistant Dean to Chairperson of Summer Salary Committee – by 5 p.m. Friday Sept. 12

Name(s):   Division:


[Individuals working together on one project in one course can submit one report with all names]

Title of Project:

Number of approved days ______
Approximate number of days you actually spent completing this project: _________

Outcome (Product)
For each outcome identified on your application or modified by Summer Salary Committee in notification letter, describe if you accomplished it or the progress you made. For tangible outcomes please submit a copy of it. [e.g. if the outcome was to be NCLEX and Blooms’ mapping of test items, then attach the Test Blueprint for the course you did and also indicate how many new test items you developed to achieve the desired relative proportions within the blueprint – For security purposes Do Not Attach Exam Questions; if outcome was to develop a new Sim Man Scenario, attach the printed scenario, list of necessary supplies, and computer print out
Coordination
Cross Campus: Indicate if any coordination with cross campus faculty occurred with their names and campus- if applicable:

Progress Toward Implementation on Own Campus

Progress Toward Demonstration and/or Implementation on All Campuses

Progress Toward Evaluation of the Project

[Note: If implementation and evaluation has not yet been accomplished, a follow-up report will be necessary to Division Assistant Dean].

Additional Support (technical, additional equipment, etc.).
Indicate if additional support was used.
Indicate if additional support was needed, but not available:
Please describe any suggestions for improving the process for summer salary awards:

Please indicate anything else you wish the Summer Salary Committee to know.


____________________________________________       _______________________
Signature of Faculty Member
    Or email from faculty member
      Date
 
____________________________________________       _______________________
Signature of Division Assistant Dean
    Or notification of approval by forwarding on email
      Date