MPRT application form

Required fields are marked with an asterisk (*).

Applicant details

Title * Example: Dr, Associate Professor, Professor.

Given name *

Family name *

Academic division *

Department/School e.g. School of Government, Melbourne Medical School

Email address *

Employment Type *

Teaching Specialist
Teaching & Research
Other

If other, please specify

Are you an Early Career Academic? *

Have you been a reviewee within the last three years in your Faculty/School peer review program? *

Are you planning to apply for promotion or confirmation in the next 12 months?

If yes, please provide the expected application date:

Subject details

Subject title *

Number of students enrolled *

What is your role in the subject?

What type of session would you like to have observed? * e.g. lecture, tutorial, workshop, lab session, online session

Nominate three classes you would like to have observed

Preference 1 * Include day, date, time and location (e.g. Monday 14-Mar-19 10:15am-11:15am Arts West-456)

Preference 2 * Include day, date, time and location (e.g. Monday 14-Mar-19 10:15am-11:15am Arts West-456)

Preference 3 * Include day, date, time and location (e.g. Monday 14-Mar-19 10:15am-11:15am Arts West-456)

Optional: Reviewer exclusion (confidential)

If your application is successful, you will be reviewed by two experts from the College of Reviewers outside your department/school. You can request that a particular reviewer not be assigned to you. Name of reviewer to be excluded:

Document upload [Note: Documents can be sent separately via email 3 weeks before review date]

Subject/Curriculum Outline (due 3 weeks before your review date) For the subject being reviewed

Teaching Portfolio (due 3 weeks before your review date) See guidelines