California State University, Fresno
2009-2010 Faculty Furlough Program
SPRING 2010 CERTIFICATION BY 12-MONTH 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:
• Furlough days are scheduled by mutual agreement between the faculty member and dean (or other appropriate administrator, if applicable).
Submit proposed dates to your department chair, who makes a recommendation and forwards them to dean for approval.
• January 15
, April 5, and May 14 are underlined in the calendar below because they are pre-designated furlough days for all faculty. Circle
these dates and propose additional furlough days through June 2010 to reach a total of 24 days in AY 2009-10.
• Propose no more than one furlough day per week and no more than two furlough days per month, including pre-designated furlough
days. Use academic workdays only (shown in bold). As an FYI, administrative furlough days are asterisked (*) and may be proposed.
• As a one-time exception during AY 2009-10 (and only if not previously used during fall semester), you may observe up to four (4) furlough
days in a single calendar month, including up to four furlough days in a single week of that month.
CIRCLE PROPOSED FURLOUGH DAYS FOR EACH MONTH:
JANUARY 2010
S M TU W TH F SA
1 2
3
4* 5 6 7 8
9
10
11 12 13 14 15
16
17 18
19 20 21 22
23
24
25 26 27 28 29
30
31
FEBRUARY 2010
S M TU W TH F SA
1 2 3 4 5
6
7
8 9 10 11 12*
13
14 15
16 17 18 19
20
21
22 23 24 25 26*
27
28
MARCH 2010
S M TU W TH F SA
1 2 3 4 5
6
7
8 9 10 11 12
13
14
15 16 17 18 19
20
21
22 23 24 25 26
27
28
29* 30*
31
APRIL 2010
S M TU W TH F SA
1* 2*
3
4
5 6 7 8 9
10
11
12 13 14 15 16
17
18
19* 20 21 22 23
24
25
26 27 28 29 30
MAY 2010
S M TU W TH F SA
1
2
3 4 5 6 7
8
9
10 11 12 13 14
15
16
17 18 19 20 21
22
23
24 25 26 27 28*
29
30 31
JUNE 2010
S M TU W TH F SA
1 2 3 4*
5
6
7 8 9 10 11
12
13
14 15 16 17 18*
19
20
21 22 23 24 25
26
27
28 39
Total Days Spring:__________
Do any of the proposed furlough days fall on your teaching days? If yes, specify days and classes (attach additional sheet if
necessary):
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 Spring 2010 (eg., 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 (M/S ML55)
Revision submitted on: _________
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