SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE

CERTIFICATION OF ORAL ENGLISH PROFICIENCY

(Please complete all areas labeled with green text, as shown on your pc screen.)

NAME OF INSTRUCTOR:

BANNER ID

DEPARTMENT:

RANK:

DATE OF HIRE:

CERTIFICATION OF THE ORAL ENGLISH PROFICIENCY OF THE FACULTY MEMBER NAMED IS BASED UPON THE FOLLOWING INDICATOR(S):

A
Peer evaluation of a classroom session
B
Teaching evaluation forms completed by students
C
Oral presentation before an on-campus audience
D
Personal conference with the department chair
E
Departmental conference attended by students and/or faculty
F
Favorable recommendation by a campus-based special review committee
G
The successful completion of developmental activities on oral language proficiency
H
Other:
FOLLOWING EVALUATION OF THE APPLICABLE INDICATORS, I CERTIFY THAT THE INSTRUCTOR NAMED ABOVE IS ORALLY PROFICIENT IN THE USE OF THE ENGLISH LANGUAGE.
DEPARTMENT OF:
NAME OF CHAIRPERSON:

SIGNATURE:
DATE OF SIGNATURE:
I accept this finding:
SCHOOL/COLLEGE OF:
NAME OF DEAN:

SIGNATURE:
I have reviewed this form:

SIGNATURE OF NAMED INSTRUCTOR:
DATE OF SIGNATURE:

PUBLIC ACT 84-1434 REQUIRES THAT ALL PERSONS PROVIDING CLASSROOM INSTRUCTION AT SOUTHERN ILLINOIS UNIVERSITY BE PROFICIENT IN THE ORAL USE OF ENGLISH. PRIOR TO THE FIRST DAY OF THE FALL QUARTER, 1987, AND THEREAFTER, EACH INDIVIDUAL WHO PROVIDES CLASSROOM INSTRUCTION MUST BE CERTIFIED AS PROFICIENT. THIS FORM, ONCE COMPLETED, WILL BECOME A PART OF THE INDIVIDUAL INSTRUCTOR'S PERMANENT PERSONNEL FILE.
1/09

SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE

SIUE

2009-01-20

OIT

SIUE