Faculty Member Name ______________________________   Evaluation Year _____

1.  Title of Article:

2.  Journal Placement:

3.  Authors of the Publication (in sequence listed in the publication):

    3a.  If multiple authored research, statement of Faculty Member's contribution:

4.  Is this research primarily?

            _____ Scholarship of Discovery

            _____ Scholarship of Application

            _____ Scholarship of Integration

            _____ Scholarship of Teaching

5.  Tier-Ranking of the Journal:  ______ Tier

6. Please attach a copy of the published article (include the cover page of the publication).