Academic Associate application form

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1 Academic Associate application form This application form is only valid from 1 July 31 December If you re joining after this time please visit cipd.co.uk/membership for the most up-to-date form or call us on +44 (0) Section 1 Your personal details Please type your details as requested. Membership number (if applicable) Grade Title Mr Mrs Miss Ms Dr Other (specify) First name Last name The name you supply will be used on any certificates and correspondence sent by us, so please state the name you d prefer us to use. Male Female Date of birth (DD/MM/YY) Home details Address Town County Work details Job title Organisation Address Town Postcode County Postcode Country Tel Mobile Country Tel By providing your mobile number, you are giving us permission to use it from time to time in order to contact you for the purposes of informing you about your membership by SMS. However we will not use it for direct marketing campaigns. Please make sure you ve supplied your address(es) above. Please send my People Management magazine, membership and branch correspondence to my: Home address Work address Please indicate if you wish to receive daily HR news and jobs by from People Management Yes, I wish to subscribe to the daily HR news and jobs bulletins by . Main focus of your job role: Lecturing Research Both If you ticked both, please enter the percentage of time spent in each area Lecturing Research Length of time in current role (years): Type of organisation: HE FE Research Other: please specify Data Protection For your security and peace of mind, CIPD and its subsidiaries will not supply your details to any organisation for marketing purposes. By submitting this application you confirm that you agree to the use of your information as set out in our privacy policy (visit cipd.co.uk/absite/privacy or call +44 (0) ) and agree to our website terms and conditions of use (visit cipd.co.uk/absite/tandc or call +44 (0) ).

2 Section 2 Your professional experience This section gives you the opportunity to provide evidence of how your work meets the Academic Associate requirements, focusing on what you do in your role and the impact your work has. You are asked to provide a varying range of examples. As a guide we are looking for approximately 500 words for each answer. Don t worry if your examples are just under or over this guidance but anything too brief is unlikely to demonstrate the criterion suitably. You should try to use a range of projects and outputs. A1. Defining or shaping HR thinking and knowledge Academic Associate members of the CIPD develop and facilitate the acquisition of knowledge and skills within the HR discipline, either in an academic or research environment. Your answers in this section should demonstrate how you have built credibility and recognition as an HR subject expert in your department, school or faculty. Please give one recent example of: A1.1: Is gradually building personal credibility and recognition as a subject expert in own department or school or faculty. Please give at least one recent example from two options A1.2: Has authored (individually or jointly) a research-based refereed article, review or other publication. A1.3: Is a valued team member on one or more research or consultancy projects and has a clear input in publicising the findings in reputable academic or professional media. In your example, please provide the following information: I. What was your main role? II. Consider what your main recommendations and /or propositions were. How do you believe these have contributed to research in, practice or the discipline of HR in general? What were the key learning points? Describe the impact and changes that resulted. Example A1.1: Example A1.2 or A1.3: Academic Associate application form Page 2

3 A2. Maintaining professionalism and standards in HR Academic Associate members of the CIPD are expected to set and exemplify professional standards in the conduct and quality of their work. Please give one recent example of: A2.1: Reflecting professionalism in own conduct and quality of work. Please give an example of at least two from four options: A2.2: Supervises first degree or postgraduate level research in a subject area across the HR discipline. A2.3: Leads subjects in the department ensuring that they meet internal and external quality requirements. A2.4: Contributes to the preparation of responses to research tenders, expression of interest and/or proposals based on sound research design principles. A2.5: Takes part in internal or external research/consultancy projects, ensuring that quality and professional standards are met. In both of your examples, please provide the following information: I. Description of the activity, when the activity took place and for how long. II. Your role and how you ensured that internal and external quality assurance requirements or standards were adhered to. III. Your contribution to innovation and quality management in your department/team through these activities. Example from A2.1: Example from A2.2, A2.3, A2.4 or A2.5: Example from A2.2, A2.3, A2.4 or A2.5: Academic Associate application form Page 3

4 A3. Advancing and extending the quality of HR practice Academic Associate members seek opportunities to gain expertise by engaging in relevant professional HR activities developing the understanding of the way the profession should be practised, the understanding of the professional standards, good practice and latest developments or topical issues and research. Please give an example of: A3.1: Seeking opportunities to gain expertise by engaging in relevant professional HR activities. Please give an example of at least two from three options A3.2: Jointly conducts (as part of a team) or occasionally leads projects for reputable organisations. A3.3: Works to build own network of contacts in order to engage with and support the industry or advance the HR profession. A3.4: Participates in funded research, policy analysis or innovative works that contribute to enhancing HR practice. In your example, please provide the following information: I. Description of the activity, when the activity took place and for how long. II. Your knowledge of relevant developments and good practice relevant to those activities. III. The knowledge exchange or transfer, amongst professionals or academics in the HR discipline. Example A3.1: Example from A3.2, A3.3 or A3.4: Example from A3.2, A3.3 or A3.4: Academic Associate application form Page 4

5 A4. Delivery of HR Knowledge We are interested in the contributions that you make towards the development of others within the profession through the dissemination of your knowledge. Please give an example of at least two from the options below: A4.1: Teaching, lecturing or assessment of an HR subject area at a first degree or Masters level. A4.2: Contributions and leads in the design, review and/or validation of modules in HR subject areas in own institution or organisation. A4.3: Active contributing to innovation in curriculum development, teaching/assessment in HR. A4.4: Assistance in the delivery and assessment of development programmes or events in a research institution. In both of your examples please provide the following information: I. What was your role and objectives? II. Please provide any supporting evidence in this section. Example from A4.1, A4.2, or A4.4: Example from A4.1, A4.2, or A4.4: Academic Associate application form Page 5

6 A5. Engaging with, leading and managing the organisation An Academic Associate member should support the achievement of their department or institution s strategic aims and objectives. Please give an example of each of the following: A5.1: Understanding of the institution or organisation s strategic direction, goals, objectives and how your role fits into these. A5.2: Key member of subject, curriculum or research team. Identifies key stakeholders and strategic decision makers in own group to build relationships with them. A5.3: Actively seeks to forge relationships within the wider institution and the external professional community to help achieve organisational goals and objectives. For each example you should include: I. For a project-based example; when the project started, its duration and how long you have been involved. II. How the activities or projects fit into your department or team s strategic objectives, your role and your key deliverables. III. The major challenges that you faced and how you overcame them. IV. How you engaged with key internal stakeholders and decision makers to gain support for those activities. Example A5.1: Example A5.2: Example A5.3: Academic Associate application form Page 6

7 A6. Developing yourself and others An Academic Associate member of the CIPD is required to use their networks to share their knowledge and expertise to advance the quality of HR practice. Please give an example of each of the following: A6.1: Keeps abreast of and sharing good practice, knowledge and experience in own team and seeks opportunities to contribute beyond its boundaries. A6.2: Proactively seeking feedback on own progress and engages in self-development activities. A6.3: Acting as a programme tutor or career counsellor to students on programmes within the department, or HR as a coach to junior staff within own team. For each example you should include: I. How you direct your own learning, and support that of others. II. Contributions that you make towards the development of others within the profession and the growth of less experienced colleagues in the profession. III. How you contribute to promoting engagement between your institution and the industry. Example A6.1: Example A6.2: Example A6.3: Academic Associate application form Page 7

8 Section 3 Membership fees New Members: To join you ll need to pay a one-off admission fee of 40 and an assessment fee of 450. You ll also need to pay a 148 subscription fee to cover membership until 30 June Your admission fee must be paid using a credit/debit card or cheque but your subscription fee can be paid by Direct Debit (single payment or instalments). You can use single payment Direct Debit for your subscription fee and this will be collected from your bank account about 3 6 weeks after we ve received your application. Cheques should be made payable to the CIPD and stapled to the form. If you re using a company cheque to pay your fees, please ensure your name is clearly stated on the back. Existing Members: Assessment fee 450 Total fee payable for existing members *This does not include subscription fees payable 450 I am already a CIPD member: Credit/debit card or cheque payment to cover the assessment fee of 450. I am a new CIPD member: Please indicate your preferred payment method: Single payment: A credit/debit card or cheque payment to cover your admission fee ( 40) and a subscription fee of 148 (to cover your subscription fee until 30 June 2016) and assessment fee ( 450). Total 638. Direct Debit: A credit/debit card or cheque payment of 490 to cover your admission fee and assessment fee and a single Direct Debit payment of 148 to cover your subscription fee until 30 June Instalments: A credit/debit card or cheque payment of 490 to cover your admission fee and assessment fee, followed by two or more Direct Debit instalments. The Direct Debit instalments will vary depending upon the month in which you join. Please find enclosed a cheque for Cheques should be made payable to CIPD and stapled to the form. If you re using a company cheque to pay your fees, please ensure that your name is clearly stated on the back. If you would like to pay for your Academic Assessment by credit card, please give us the best number to contact you on and we will call to take your payment. Telephone. For office use only Membership number: Academic Associate application form Page 8

9 Chartered Institute of Personnel and Development Instruction to your bank or building society to pay your subscription fee by Direct Debit Chartered Institute of Personnel and Development, 151 The Broadway, London, SW19 1JQ Originator s Identification Number: Name and full postal address of your bank or building society Reference To: The Manager Bank/building society name To be completed by the applicant (this is not part of the instruction to your bank or building society) Address Preferred payment option: Postcode Single payment (see note 3) Name(s) of Account holder(s) Instalments (see note 3) Your name Branch Sort Code Bank/building society account number Instruction to your bank or building society Please pay the Chartered Institute of Personnel and Development (CIPD) Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with the CIPD and, if so, details will be passed electronically to my bank/building society Signature(s) Date Only available to UK bank account holders Banks and building societies may not accept Direct Debit Instructions for some types of account Please keep this Direct Debit guarantee for your own records. The Direct Debit Guarantee If there are any changes to the amount, date or frequency of your Direct Debit the Chartered Institute of Personnel and Development (CIPD) will notify you ten working days in advance of your account being debited or as otherwise agreed. If an error is made in the payment of your Direct Debit by the CIPD or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when the CIPD asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us. Notes: 1 Your subscription fee is renewable on 1 July 2016 and then annually on 1 July. 2 All amounts are shown in pounds sterling. If you prefer, you can make a payment by cheque in Euros using and exchange rate of 1 = If you pay by credit/debit card, your provider will use their own exchange rate. 3 Important information for Direct Debit payers The Direct Debit payment option is only available for UK bank account holders. If you would like to pay by Direct Debit please follow the instructions below. Your admission fee must be paid when you join by cheque or card. The Direct Debit option allows you to have your subscription fee collected automatically on the due date in this and future years. The payment date(s) in your first year will depend on the time of year that you join us. Single payments. If you prefer to make a single payment for the full amount of your subscription then tick the box marked Single payment. We will collect the first payment 3 6 weeks after receiving your application. When your subscription comes up for renewal, payments will be collected each year on 1 July until you advise us otherwise. We ll send you a membership renewal pack at the start of June each year to remind you how much is due. Direct Debit instalments. If you prefer to pay by instalments then tick the box marked Instalments. In order for your membership to remain valid, your Direct Debit payments must be kept up to date. Once we ve received your completed Direct Debit instruction we ll send you a payment schedule for the collection of your subscription fee. Depending on your joining date, in your first year of membership the instalments will not necessarily be quarterly, but will be spread across the subscription year. In your second and subsequent subscription years we will continue to collect your subscription in quarterly instalments. You can cancel this arrangement at any time. We ll send you a membership renewal pack in June each year to remind you and let you know how much is due. If you re not the account holder or your bank account requires more than one person to authorise Direct Debits (for example, a company account), then you should use an alternative method to pay your membership. Academic Associate application form Page 9

10 6 Some benefits and services may not be available to members outside of the UK and Ireland. At its absolute discretion, CIPD may at any time alter, amend, change, modify or withdraw any of the membership benefits that comprise the membership offering. Application checklist Copy of highest qualification certificate Please check Web links and/or publication references for published works listed in your application Copy of your CV attached Copy of your job description attached (Where this is not available, please provide alternative evidence from your institution) Academic Associate Referee Assessment Senior Colleague/Expert reference submitted to referee for completion Referee s Name Referee s Job Title Relationship Academic Associate Referee Assessment Line Manager/Supervisor reference submitted to referee for completion Referee s Name Referee s Job Title Application form including contact details and payment details completed Once printed, all relevant sections have been signed Relationship How did you hear about Academic Membership? Do you know anyone who may be interested in Academic membership? If so, please provide details. Academic Associate application form Page 10

11 Chartered Institute of Personnel and Development You can return your completed application form (attaching your CV and job description) either by post or . Post: Academic Associate Membership Administration CIPD 151 The Broadway London SW19 1JQ Provided we have all the details we need from you, your assessment will be completed and a report issued to you within six to eight weeks. Existing CIPD members If you re already a member, you ll still need to complete this form so that we can update your records. If you ve paid your subscription fee for this year, you don t need to pay any more membership fees, just your assessment fee. I confirm that the information that I have provided above is complete and accurate. I also give CIPD permission to verify information with any third parties that I may have named in support of my application where required. I confirm that I have read, understand and agree to comply with the CIPD Code of Professional Conduct (available at cipd.co.uk/codeofconduct): Yes Name: Date: No Signature: By joining the CIPD as a member you re accepting that the Membership Terms and Conditions will apply to you, see: cipd.co.uk/memberterms or call +44 (0) For office use only Membership number Chartered Institute of Personnel and Development 151 The Broadway London SW19 1JQ United Kingdom Tel: +44 (0) Fax: +44 (0) E: W: cipd.co.uk Incorporated by Royal Charter Registered as a charity in England and Wales ( ) and Scotland (SCO45154) Academic Associate application form Page 11

12 1 Chartered Institute of Personnel and Development Issued: September 2015 Reference: 7036AA FINAL Chartered Institute of Personnel and Development 2015 Academic Associate application form Page 12

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