Queen’s Merit Award Registration FormWelcome to the Professional Recognition Scheme at Queen’s University Belfast leading to Fellowship of the Higher Education Academy (HEA). This registration form must be completed, signed by your Line Manager, Head of School or PhD Supervisor (if applicable) and submitted to qma@qub.ac.uk. Once your registration is complete, you will be sent an email inviting you to sign up for an induction workshop and providing you with essential details on submitting your QMA application.

The purpose of this form is to allow you to provide a brief overview of your higher education career and your teaching and/or supporting learning roles and responsibilities to date. Before you submit this registration form you should consult the Queen’s Merit Award Website (https://www.qub.ac.uk/directorates/AcademicStudentAffairs/CentreforEducationalDevelopment/CoursesEventsProfessionalRecognition/ProfessionalRecognition/HEA/) to familiarise yourself with the programme and the different categories of Fellowship.

You may also wish to talk to your Line Manager, Head of School or PhD Supervisor to gain advice and/or contact the QMA Programme Lead if you have any questions.

QMA Programme Lead: Karen Fraser (qma@qub.ac.uk), 5865

QMA Administrator: Lina Furnell (qma@qub.ac.uk), 5845

Section A – Personal and Factual Details

Personal Details

TitleFirst NameSurnameJob roleContact emailSchool/Department/InstituteLine Manager, Head of School or PhD Supervisor

(enter details if applicable)

Fellowship Details Intended HEA Fellowship (Please tick one)Associate Fellow Fellow Senior FellowIntended Submission Date for Application*Upcoming submission deadlines Panel sessions (Please tick one)4th May 2020 24th June 202018th September 2020 4th November 202015th January 2021 3rd March 202130th April 2021 16th June 2021

*Note: If panels are oversubscribed, submission dates will be allocated on a first come, first served basis.

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Section B – Pathways to the Queen’s Merit Award

Applicants are required to attend an initial induction workshop where the method of submission for your chosen category of fellowship will be explained in detail. You can visit the QMA Website to download the Guidance for applicants and read the specific information about application routes for each category. The table below summarises the various options to work towards submitting an application:

Queen’s Merit AwardName Descriptor Status

Introduction to Teaching for Postgraduate Researchers (Taught route)

Descriptor 1 (AFHEA)  Accredited

Postgraduate Certificate in Higher Education Teaching (PGCHET - Taught route)

Descriptor 2 (FHEA)  Accredited

Supporting Student Learning (Taught route)

Descriptor 1 (AFHEA)  Accredited

Experiential route Descriptor 1 (AFHEA)  AccreditedExperiential route Descriptor 2 (FHEA)  AccreditedExperiential route Descriptor 3 (SFHEA)  Accredited

Section C – Your QMA Mentor All applicants will have the option of working with a QMA Mentor whilst writing their application, who will provide specific and bespoke support in relation to the application writing process. The mentor will not support or coach applicants in any other areas of their professional practice. Associate Fellowship applicants are supported directly by the programme lead and will not have an individual QMA mentor.

Some applicants will identify a local mentor (i.e. within their own department/school/institute) in discussion with their Line Manager/Head of School/PhD Supervisor and/or the QMA programme lead. Individuals should not be mentored by their line manager or Head of School, i.e. the relationship will be non-hierarchical and outside of the normal line management relationship.

The most important factor for applicants when considering choice of mentor, is that the mentor has a good understanding of the UKPSF and familiarity with the QMA application processes and procedures. All of the QMA trained mentors have expert knowledge of the UKPSF and QMA; most are Senior Fellows (as well as some Fellows and Principal Fellows) of the HEA that have previously completed the QMA programme.

If you have identified a mentor before submitting this form please indicate the name of your mentor below. If you would like to be allocated a mentor after the induction workshop, please leave this section of the form blank for now.

Name of Mentor:

Mentor Job Position/Role:

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Section D – Teaching and/or Supporting Learning Roles and ResponsibilitiesIn this section please briefly outline your principal teaching and/or supporting learning roles and responsibilities within your current job role at Queen’s, and then more broadly over the last 5 – 10 years (if applicable). Roles and responsibilities listed need to be relevant to the category of fellowship you are applying for.

Please note: applicants for Associate Fellowship must indicate their total number of hours experience of front-line delivery to learners, e.g. lecturing, facilitating seminars/tutorials/workshops, 1:1 supervision, lab demonstration that involves teaching activities, online tutoring/distance learning, etc.

Current Teaching and/or Supporting Learning Roles and Responsibilities at Queen’s

*please add rows as needed*

From To

Teaching and/or Supporting Learning Roles and Responsibilities over last 5 – 10 Years

*please add rows as needed*

From To

Section E – Professional Development Activities

Please briefly outline the principal CPD activities you have engaged in over the last five years in relation to the development of your teaching, learning, assessment, scholarship, academic and professional practice. Include details of any relevant pedagogic research, publications, presentations and awards. Please limit your entries to what is most relevant to your application.

Professional Development Activities*please add rows as needed*

From To

Section F – Referees and Advocates

Please provide the names of your two referees for Associate Fellow, Fellow and Senior Fellow (download the Guidance for applicants on the QMA Website for advice on choosing referees/advocates and other details specific to each fellowship category).

Referee 1/Advocate 1 Referee 2/Advocate 2NameJob PositionEmail

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Section G – Sign and Date Please complete, sign and date your registration form and forward it to your Line Manager, Head of School or PhD Supervisor for endorsing and signing (if applicable). Please then send your completed form to qma@qub.ac.uk; you will receive notice of its receipt. Once you are registered for the QMA, you will be sent an email inviting you to sign up for an induction workshop and providing further instructions.

Date:

Signed by Applicant:

Signed by Line Manager/Head of School/PhD Supervisor: (enter n/a if not applicable)

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