Faculty Sabbatical Leave of Absence Application
Submit your request for a sabbatical leave of absence. Please complete all sections accurately to ensure timely review and processing.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department/Faculty
*
Please Select
Arts and Humanities
Sciences
Engineering
Business
Education
Health Sciences
Other
Academic Position/Rank
*
Please Select
Professor
Associate Professor
Assistant Professor
Lecturer
Instructor
Researcher
Other
Type of Sabbatical Leave Requested
*
Full Academic Year
One Semester (Fall)
One Semester (Spring)
Other
Proposed Start Date of Sabbatical
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Proposed End Date of Sabbatical
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Purpose and Plan for Sabbatical Leave (Please describe your objectives, activities, and expected outcomes)
*
Have you previously taken a sabbatical leave at this institution?
*
Yes
No
If yes, please provide the year(s) and duration of previous sabbatical(s)
Arrangements for Covering Teaching/Administrative Duties During Absence (Please specify who will cover your responsibilities)
*
Supervisor/Department Head Name
*
Supervisor/Department Head Email
*
example@example.com
Signature of Applicant
*
Submit Application
Submit Application
Should be Empty: