Appointee Name Rank College/Department. UTA ID Date of Appointment Status (FT/PT) Form Completed by:

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Certification of Credentials and Qualifications Form (CCQ) This form documents that full-time and part-time primary instructors hired by The University of Texas at Arlington meet the qualifications established by the Southern Association of Colleges and Schools (SACSCOC). Appointee Name Rank College/Department UTA ID Date of Appointment Status (FT/PT) Form Completed by: INFORMATION ON DEGREES EARNED Level Type of Degree (Ph.D., Ed.D., MSW, etc.) Doctorate Degree Discipline Year Awarded Institution Awarding Degree, Location and CIP Code Masters Degree Undergraduate Degree Other (licensures, credentials, etc. that are relevant to teaching assigned courses) CIP Codes available at http://www.txhighereddata.org/interactive/cip/ 1

COURSE ASSIGNMENTS Course Prefix EXAMPLE: HIST 1312 Full Title of Course & Credit Hours History of the United States, 1865 to present (3) Course Level (Undergrad or Graduate) Does faculty member hold terminal degree in this discipline? Course Description Undergrad YES An introduction to the political, social, economic, and cultural history of the United States since 1865 including Reconstruction; the Gilded Age; Civil Rights; American Imperialism; the Cold War; twentieth century politics. 2

Is the appointee a member of the Graduate Faculty? Yes No UT Arlington s HOP Section 4-206 states: Only full members of the Graduate Faculty may teach graduate courses, serve on graduate student supervising committees, serve on committee(s) on graduate studies, supervise master's theses and doctoral dissertations, and vote in all Graduate faculty functions. Please see HOP Section 4-206 for requesting certification of membership in the Graduate School. Is an official transcript for the highest earned degree on hand? Is a current curriculum vitae (CV) on hand? Yes No Yes No Degree Equivalency Evaluation: A candidate whose highest degree was awarded by an institution NOT accredited by a regional accrediting agency equivalent to SACSCOC (i.e., a foreign institution or non-accredited U.S. institution) must have their educational credentials evaluated for equivalency and the results placed in the appointee s file. Please make sure to note that the purpose of the verification is for employment. SpanTran Educational Services: www.spantran-edu.org 2400 Augusta Drive, Suite 451 Houston, TX77057 Telephone: 713.266.8805 Transcript evaluation has been requested: Yes No If the degrees earned match the anticipated teaching assignments and if the degree level is appropriate for the level of courses to be taught, no further documentation is required beyond this form, official transcript, and vitae. If faculty qualifications for teaching courses in the target discipline at the desired level cannot be established based on the SACSCOC standards both this form [Certification of Credentials and Qualifications Form] AND a Supplemental Qualifications Form must be approved prior to an offer being made. Department Chair Dean Provost s Office Graduate Dean (only if teaching grad courses)

Supplemental Qualifications Form for Faculty Credentials UT Arlington recognizes that instructors may bring an unquestionable level of advanced accomplishment in their field that may not include the typical academic credentials. SACSCOC 3.7.1 provides an opportunity for departments to present a justification with strong evidence of advanced accomplishment of the prospective faculty member to deliver the assigned instructional material. The evidence may include: related work experience, professional licensure and certifications, honors and awards, continuous documented excellence in teaching. Appointee Name Rank College/Department UTA ID Date of Appointment Status (FT/PT) Form Completed by: If faculty qualifications cannot be established using standard SACS criteria and earned degrees at the appropriate levels, and/or does not hold a terminal degree in the teaching discipline, provide additional justification for the anticipated teaching assignment by completing all of the sections below.

UT Arlington Supplemental Qualifications for Faculty Credentials Form Please Use One Form Per Faculty Member Course(s) Taught (include term, course number & title, credit hours) Course Learning Outcomes Academic Degrees & Coursework (relevant to courses taught, including institution & major) Other Qualifications and Comments (related to learning outcomes for courses)

Instructor Name (Full- Time, Pat- Time) Jessica Jones (FT) Daniel James (PT) SAMPLE COPY [Please Use One Form Per Faculty Member. Examples Below are Illustrative Only] Course(s) Taught Course Learning Outcomes Academic Degrees & (include term, Coursework (relevant to course number & courses taught, including title, credit hours) institution & major) Fall 2015 HIST 1312 History Of The United States, 1865 To Present (3) Spring 2016 MUSIC 5366 Jazz Style and Analysis (3) Analyze and compare political, geographic, economic, social, cultural, religious and intellectual institutions, structures, and processes across historical periods and cultures Recognize and articulate the diversity of human experience across a range of historical periods and the complexities of a global culture and society Analyze the contributions of past cultures/societies to the contemporary world. Analyze the improvisational techniques used by prominent jazz musicians. Master transcription and theoretical analysis over different periods and styles in jazz. Ph.D. in Sociology, 2003, University of California San Diego ETHS 4312 History of the U.S. from an ethnic studies perspective (3) SOC 5320 Global Cultures and Society (3) HIST 5523 Interpreting History and Social Institutions (3) SOC6207 Comparative Historical Methods (3) SOC 6214 Urban Sociology (3) HIST 5207 Nationalism, Colonialism and Race (3) HIST 5271 New Research Directions in U.S. History (3) BM (Music Performance), Berklee College of Music Other Qualifications and Comments (related to learning outcomes for courses) Meets minimum 18 graduate degree on teaching discipline or related. Chair, the Dallas Historical Society and winner NEH grant to document oral histories of African Americans in DFW. Awarded White House commendation for preserving DFW African American history. Grammy Award winner (2013); performs regularly with other Grammy winners; taught 2 music courses for masters students at Berklee College of Music in Spring12 and Spring 13 with high course reviews (attached).