9/28/99 Approved
INFORMATION REQUESTED
1. Experience in college teaching, research, or related professional activity prior to joining the Lamar
State College-Port Arthur faculty.
2. Description of teaching and research assignments at Lamar State College-Port Arthur, particularly
in your present position. Not courses in the department offering for which you are responsible.
3. Research projects completed or underway.
4. Fellowship and grants previously held.
5. Services rendered to Lamar State College-Port Arthur beyond regular teaching assignments (administrative
or semi-administrative duties, curriculum development, committee work, special assignments).
6. Professional activities: memberships (and especially offices) in professional societies.
7. Community services.
8. Publications, especially any related to the area of study indicated in the application for leave of absence.
9. Date of last leave of absence, of whatever sort, with description of its purpose.
10. Full statement of the purposes for which this leave is requested, both general and specific, in accord with
the purposes of the Development Leave Program. Make clear ways in which your project will enrich any
of the following: yourself, your division, and the college as a whole.
11. Any other financial aid in the form of grants, fellowships available to you or being sought.
12. Sponsorship or recognition (but without financial assistance) of your proposed project by any professional
organization, other institution, or the like.
13. Formal courses, if any, to be taken in a university. Libraries to be used; research facilities to be used.
Explain especially the need to maintain residence for specific periods of time elsewhere than in the Port
Arthur area.
14. Statement of plans to combine portions of the semester after the period of leave with the activities for
which the leave is requested.
15. Statement of your present intention to remain in the profession and to continue service at Lamar State
College-Port Arthur.
16. Attach supporting evidence from your Program Director/Department Head and the Dean of your division.
In addition to indicating whether an application can be spared by the department for the leave period, the
Program Director and the Dean should provide some assessment of proposal’s merit.
17. While the Development Leave Committee will, of course, give careful attention to such information, its
ultimate recommendation to the President may or may not coincide with the assessment of the Program
Director/Department Head and/or Dean.
18. Signature of the applicant.