Fillable Fvtp Application Form (Oral Roberts University)

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Fvtp Application Form (Oral Roberts University)

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1 ORUkrm.cm112916
ORAL ROBERTS UNIVERSITY
FACULTY VOLUNTARY TRANSITION PLAN
APPLICATION FORM
Submit this Form to Provost on or before December 31, 2016
SECTION I: FACULTY INFORMATION
Date of Birth (Month/Day/Year) ______________________ Z Number: _______________________
First Name MI Last Name
___________________________________ ______ __________________________________________
Street or Mailing Address
_________________________________________________________________________________________
City State Zip Code
_________________________________________ ______ ______________
Home Phone Work Phone Cell Phone
_______________________ _____________________ _____________________
Email Address: _____________________________________________________________________________
SECTION II: ELIGIBILITY/QUALIFICATIONS
A. Faculty member’s first day of employment at ORU as Full Time Faculty. ____________________
B. Faculty member’s last day of employment at ORU as Full Time Faculty. ____________________
C. Faculty Member’s age as of December 31, 2016 ____________________
D. Faculty Member’s years of continuous service as faculty at ORU
as of December 31, 2016. ____________________
E. Faculty Members age and years of continuous service (Total of C & D). ____________________
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2 ORUkrm.cm112916
SECTION III: RREPRESENTATIONS
I have received and read ORU’s Faculty Voluntary Transition Plan (FVTP) dated November 2016. By
completing this Application and executing below, I understand that:
A. Participation in the FVTP is an opportunity offered by ORU and not an entitlement.
B. ORU may refuse an applicant to participate in the FVTP if it determines there is reasonable cause to do so.
C. The FVTP is offered on a one-time basis and the Election Period is November 1, 2016 to December 31,
2016.
D. The voluntary resignation date for Qualified Faculty members is May 31, 2016, however, the Voluntary
Resignation Date for academic administration or academically related administration personnel may vary
based on operational needs.
E. Election and participation in the FVTP is strictly voluntary. The decision whether to elect to participate in
the FVTP is entirely within the discretion of the applicant.
F. As a condition of participation in the FVTP, I will execute a Transition and Release Agreement with ORU
that includes the terms and conditions of separation.
G. I cannot be reemployed by ORU in any full-time or staff position for five (5) years following my voluntary
resignation date.
SECTION IV: SUBMISSION, RECEIPT AND APPROVAL
I AM A Full Time Faculty member and my age plus continuous years actively employed as Full Time Faculty
member at ORU are equal to _________(actively employed means being actively at work; on vacation; on sick
leave; on military leave; on paid leave of absence; or on an approved unpaid leave of absence). By signing
below, I voluntarily request participation in the FVTP.
Employee Date: Month/Day/Year
Signature: __________________________________________________ ______/_______/_______
Application Approved by: Date: Month/Day/Year
___________________________________________________________ _____/_______/________
Dr. Kathaleen Reid-Martinez, Provost
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Fvtp Application Form (Oral Roberts University)

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Completed 20 July 2020

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