Help us Recognize Your Accomplishments

CUPE 3911 members are extremely qualified and talented academics and professionals. We feel their accomplishments should be better shared within AU and with the broader public. Please take a few minutes to tell us about your academic and professional credentials and accomplishments. Providing this information is voluntary and it will be included in a CUPE 3911 Member Credentials Report that will be published on our website - www.cupe3911.com.

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* 1. By completing this form, I consent to CUPE 3911 including my information in their CUPE Member Credentials Report. I have provided accurate and current information about myself and I understand the information I am providing will be shared on the CUPE 3911 website and with the various administration at Athabasca University.

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* 2. First Name

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* 3. Last Name

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* 4. What is your position at AU? Please check all the apply.

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* 5. Please list all Faculties you teach in at Athabasca University.

Ex.
Faculty of Humanities and Social Sciences
Faculty of Science and Technology

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* 6. Please list all institutions you teach at:

Ex.
Athabasca University
University of ABC
XYZ College

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* 7. Please list all your educational degrees, starting with the most recent. Please list as follows:

Ex.
2010: University of XYZ, PhD
2006: University of ABC, MBA
2000: University of EFG, BA

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* 8. Please list any professional licenses or credentials you may possess, with no periods:

Ex.
PEng, PMP

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* 9. Please list any awards you have received, starting with the most recent:

Ex.
2002: Award for ABC
2000: XYZ Award for EFG

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* 10. Do you have other projects, work, or accomplishments you would like to share with us (volunteer roles, MOOCs, non-traditional forms of education, etc.)? Please list below:

Ex.
Chair of Organization ABC
Executive Member of XYZ

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* 11. Please list any of your publications (APA format):

Ex:
Author, A. (Year). Title of article. Title of Periodical, volume number(issue number), pages. http://dx.doi.org/xx.xxx/yyyyy

Author, A. (Year). Title of second article. Title of Journal, volume number (issue number), pages.

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* 12. Personal Emails:

As you might have seen in previous emails, CUPE is working to create a non-AU email list for our members. This is important because AU owns AU emails and we need a way to contact you, especially since we are currently in bargaining. Please provide us with a personal email that we can use in the event your AU email is not available, or for correspondences about union business we prefer to keep private (e.g. bargaining). This will not be used for the Credentials Report and is for our records only - your personal email will not be shared with anyone:

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