Fillable Fvtp-application-form-103118 - FVTP Application REV10.31.2018

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Fvtp-application-form-103118 - FVTP Application REV10.31.2018

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1 ORUkrm.cm092618
ORAL ROBERTS UNIVERSITY
FACULTY VOLUNTARY TRANSITION PLAN
APPLICATION FORM
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 Month Day Year
A. First day of continuous employment at ORU as Full Time Faculty. _____ _____ ____
B. Last anticipated day of employment at ORU as Full Time Faculty. _____ _____ ____
C. Faculty Member’s age as of application date. __________________
D. Number of academic years of continuous service prior to August 2013. __________________
E. Faculty Members age and academic years of continuous service prior
to August 2013 (Total of C & D). __________________
2 ORUkrm.cm092618
SECTION III: REPRESENTATIONS
I have received and read ORU’s Faculty Voluntary Transition Plan (FVTP). 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 to December 31 of each
year.
D. The voluntary resignation date for Qualified Faculty members is May 31 of each year, 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 academic years actively employed as Full Time
Faculty member prior to August 2013 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.
Date: Month/Day/Year
Employee
Signature: __________________________________________________ ____________________
Application Approved by: Date: Month/Day/Year
___________________________________________________________ ____________________
Dr. Kathaleen Reid-Martinez, Provost
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Fvtp-application-form-103118 - FVTP Application REV10.31.2018

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Completed 21 February 2020

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