Application for Professor Emeritus Status

Please provide the following information:

Name: *

Street address:

City:

State:

Zip code:

Phone: *

Email address: *

Academic Department:

Years of full-time service at CCRI: *

Date of retirement: *

Number of years in rank of Professor: *

Examples of meritorious contributions in your field: *

Examples of your dedication to CCRI and to teaching: *

Examples of high esteem held by your students and colleagues: *

Examples or quotes from Student Ratings of Instruction (SRI): *

Examples of participation in departmental and institution-wide committees: *