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Request for Consideration of Emeritus/a Status

Use this form to initiate a request for Emeritus/a status for a retiring faculty member. Visit the Emeritus/a Faculty page for criteria related to this status. The process commences with the departmental and/or program Chair providing written recommendation of emeritus/a status to the Dean of Geisel School of Medicine. This recommendation, supported by the candidate’s curriculum vitae, should clearly and specifically document the academic accomplishments and the value the individual has provided to the missions of the Medical School. The Dean, should they concur, will then make their own to the Provost.  The change to emeritus/a status must be approved by the Provost, the President, and the Dartmouth College Board of Trustees.

Entries marked with * are required.

Faculty Member Name*:


Retirement Date*:

Contact Name*:

Contact Email*:

Chair recommendation letter to Dean*: