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									           RECOMMENDATION FOR PROMOTION OF PROFESSIONAL RESEARCH PERSONNEL
                            GEORGIA INSTITUTE OF TECHNOLOGY

BIOGRAPHICAL INFORMATION:
Name:
                      (Last)                                       (First)                               (Middle)
GTID Number:
Recommended Rank:                                                          Administrative Unit:
Immediate Supervisor:
                                                (Name)                                                   (Title)
Total Years of Relevant Full-Time Experience:
Total Years at Georgia Tech:                                       Total Years in Present Rank:
Georgia Tech Title History: (most recent first)
                                                                                       Inclusive Dates
                     Title:                                          Month/Year




If employment has not been continuous since initial appointment, explain:


ACADEMIC DEGREES HELD: (most recent first)
                                                                                                    Date Awarded
        Degree:                               Institution                                            Month/Year




OTHER RELEVANT FULL-TIME EMPLOYMENT SINCE BACHELOR'S DEGREE: (most recent first)
        Rank:                                 Employer:                                             Dates:




I hereby certify that the information contained in this document constitutes an accurate representation of my
professional career.

                     Signature of Candidate                                                                        Date


PEER AND ADMINISTRATIVE ACTIONS:
                                              Promotion     Nonpromotion        Yes-No-Abstain    Comment

Unit Peer Committee
Unit Director
Dean/GTRI Director/VPIP Committee
Dean/GTRI Director/VPIP
Vice President's Committee
Executive Vice President for Research
President


                     Unit Director                                                                                 Date


                     Dean/GTRI Director/VPIP                                                                       Date


            Executive Vice President for Research                                                                  Date


                     President                                                                                     Date

								
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