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INSTRUCTIONS:
1. In "Row 3" enter in each required and preferred qualification. Complete the form based on observed information relevant to the required or preferred qualifications.
2. Review applicant materials and document which required and preferred qualifications each candidate meets.
3. Assign each candidate to a Tier based on the following Key:
Tier 3 - Meets
all required and most preferred qualifications
Tier 2 - Meets
all required and some preferred qualifications
Tier 1 - Does
not meet the required qualifications
4. If only some but not all of the Tier 3 candidates are selected to advance, discuss and document their strengths and opportunities based on the required and preferred qualifications. Do the same for Tier 2 if only some but not all Tier 2 candidates are selected to advance.
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APPLICANT
UMN EMPLOYMENT
Reach out to HR if there is a current/former UMN employee or a conflict of interest is known.
REQUIRED QUALIFICATIONS
Place an X under each qualification demonstrated in the application material. Place a ? if unknown.
PREFERRED QUALIFICATIONS
Place an X under each qualification demonstrated in the application material. Place a ? if unknown.
TIERS
Mark with 1, 2, or 3
COMMITTEE DISCUSSION
ADVANCE TO SCRENNING INTERVIEW
Mark with Yes or No
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NameCurrent Med School EmployeeCurrent UMN Employee (Non Med)Former UMN EmployeeRequired Qual 1Required Qual 2Required Qual 3Required Qual 4Required Qual 5Required Qual 6Required Qual 7Preferred Qual 1Preferred Qual 2Preferred Qual 3Preferred Qual 4Preferred Qual 5Preferred Qual 6Preferred Qual 7Assigned TierStrengthsOpportunitiesRecommend
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