APPENDIX V
SABBATICAL LEAVE APPLICATION
TITLE PAGE
Name: Date:
Department:
Date of Full-Time Employment at the College: _______________________________________
Date of Previous Sabbatical (If Any): ______________________________________________
Length of Sabbatical Requested _____ Full-Year _____ Half-Year _____ Semester
If Requesting a Half-Year Sabbatical, please choose one of the following.
_____ Summer D session and Fall Semester ______ Spring Semester and Summer B session
If Requesting a One Semester Sabbatical, please choose one of the following.
_____ Fall Semester _____ Spring Semester
The following signatures do not necessarily imply approval, but are necessary for appropriate
notification to supervisors:
Department Head
Dean
Total application must be typed and
cannot exceed four (4) 8 ½” x 11" pages.
If you are chosen for a sabbatical leave, you will be required to sign a contract
which specifies the required employment period following the return from the leave.
Approval of pursuit of a degree or coursework contained within the sabbatical
application does not imply approval for the Educational Achievement Incentive Pay.