California State University, Fresno
2009-2010 Faculty Furlough Program
FALL 2009 CERTIFICATION BY FACULTY MEMBER
In accordance with Paragraph 5.b. of the Furlough Agreement dated July 28, 2009, between The California State University and the
California Faculty Association, I certify that:
i. I will not work on mutually agreed or assigned furlough days; and
ii. I will not work beyond the duties assigned for any week in which I have one or more furlough days.
Print name: _____________________________________________ Dept: _______________________
Signature: _____________________________________________ Date: _______________________
Instructions for selecting proposed furlough days:
• Scheduling of furlough days is by mutual agreement between the faculty member and dean (or other appropriate administrator,
if applicable). Submit proposed dates to your department chair, who will forward the request to the college or school dean.
• September 4 and December 11, 2009, are presidentially-designated days. Propose seven (7) additional furlough days for the
fall semester. (Spring furlough days will be arranged separately.)
• Propose no more than two (2) furlough days per month, inclusive of any presidentially-designated day(s); and no more than
one (1) furlough day per week.
• As a one-time exception to these limitations, you may observe up to four (4) furlough days in a single calendar month,
including up to four (4) furlough days in a single week of that month, during AY 2009-2010.
Are any of these proposed furlough days instructional
Proposed faculty furlough days: days? If so, specify the affected classes:
August ________________ __________________________________________________
September 4 ________________ __________________________________________________
October ________________ __________________________________________________
November ________________ __________________________________________________
December 11 ________________ __________________________________________________
Total Days Fall: ________________
My salary is partially or fully-funded by grant(s) or contract(s), which have been fully-approved. I have attached a copy of the
completed RTC with all signatures. I have been released ______ wtu for Fall 2009. (Example 3 wtu or 6 wtu)
RECOMMENDED: Yes
No
________________________________________________ ____________________________
Department Chair’s Signature Date
APPROVED:
________________________________________________ ____________________________
Dean’s (or other appropriate administrator’s) Signature Date
REMINDER: REPORT MONTHLY FURLOUGH DAYS IN ABSENCE MANAGEMENT
Completed original will be placed in your Open Personnel File five days after copy is delivered to faculty member.
C
OPIES: Faculty Member
Department Chair
Academic Personnel (MS ML55)
Revised 8/14/09
