California State University, Fresno
2009-2010 Faculty Furlough Program
SPRING 2010 CERTIFICATION BY ACADEMIC YEAR 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 six additional furlough days for the spring 2010 semester.
• Propose no more than one furlough day per week and no more than two furlough days per month, including pre-designated furlough
days. Use only academic workdays (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 2009 semester), you may observe up to four
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 (12-MO. FACULTY ONLY)
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 (e.g., 3 WTU. 6 WTU, etc.).
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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