CBE Workload Request
(To Be Given to the Department Chair by April 30, 20____)
Name:
Department: ___________________________________ _______
My faculty Qualification Status is:
Scholarly Academic (SA)
Practice Academic (PA)
Scholarly Practitioner (SP)
Instructional Practitioner (IP)
Other (O)
I would like to apply for:
3-3 teaching load for the upcoming year
3-4 teaching load
4-4 teaching load
Documentation of Intellectual Contributions (Attach additional information, if any.)
1) Completed in the time period June 1, 20 through May 31, 20 :
A. R
efereed Journal Articles:
B. O
ther:
2) Forthcoming in the time period June 1, 20____ through May 31, 20____:
(Indicate the current status: accepted, submitted, manuscript, etc)
A. Ref
ereed Journal Articles:
B. O
ther:
Signed
Faculty Member Date
Assigned a ______ teaching load:
Chair Dean Date
Other