Salary Match Documentation Form
(signatures indicate approval of proposed salary match for grant proposal)
Grant name or Index Code: __________________________________________________________________________
Matching Department name or Index Code: ______________________________________________________
_____________________________________________________ ____________________________________ ___________________
Faculty Member (faculty name printed) signature date
_____________________________________________________ ____________________________________ ___________________
Department Head (printed) signature date
_____________________________________________________ ____________________________________ ___________________
Dean (printed) signature date
_____________________________________________________ ____________________________________ ___________________
Vice President for Academic Affairs (printed) signature date
Grant duration (proposed): work begins:______________________ work ends _____________________
Proposed salary match over the grant duration: $________________________
Note: Salary match is based on the portion of professional salary not associated with one’s full-time teaching obligation. This
includes departmental expectations in areas of scholarly activity and service (as appropriate to the grant) as well as “release
time” from normal teaching loads. The lower portion of this form is to indicate whether the match is based on release time,
departmental expectations, or both. Furthermore, if this grant is funded, the Faculty Member must file a monthly Time and
Effort Report for the duration of the grant or until the match is satisfied to document time spent on this grant.
I. Is a portion of the Faculty Member’s salary already committed for match on another grant overlapping the duration of
this proposal?: If yes, attach a copy of the “SALARY MATCH DOCUMENTATION FORM” relative to all other obligations. If no,
continue
.
II. Faculty Member’s current base salary: $_____________(circle one: 9-month, 12-month, other_________)
NOTE: Nine-month salaries cover approximately 1,560 work hours; whereas, 12-month salaries cover 2,080 hours.
III. Match based on departmental annual evaluation weighting:
Planned annual evaluation weighting: Teaching _____ Scholarship _____ Service _____ Administration ________
(must total 100%) (60-80%) (10-30%) (10-30%) (50-100%)
Evaluation Weight Category
Percentage of Weight
to be matched
V. Match used towards Summer Pay:
Percentage of Base Pay
to be used as Match
*Please note that fringe benefit calculations will be provided by the Budget Office. Please call 479-964-0821
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
