OAPL-LeaveWithoutPayRequest | Rev. 2/27/19
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CALIFORNIA STATE
UNIVERSITY CHICO
Office of Academic Personnel
Kendall Hall Room 104
400 W. 1st Street
Chico, CA 95929-0024
530-898-5029
FAX: 530-898-4438
Application for
Leave of Absence
Without Pay for Faculty
Name: Date:
College:
Department/School:
Status:
(check one only)
Faculty
Counselor
Librarian
(check one only)
Probationary
Tenured
Temporary
FERP
Dates of Proposed Leave:
FALL 20 SPRING 20 ACADEMIC YEAR 20 - 20
Other: From
To
Extension of Current Leave:
Yes No
Full-Time Leave Part-Time Leave
If Part-Time % of timebase
Type of Leave Requested:
Professional Personal*
* If you are requesting a Personal Leave of Absence Without Pay for medical reasons (self or family, birth or placement of a child), or
military leave entitlements, and have not yet verified your eligibility for FMLA leave please DO NOT FILL OUT OR SUBMIT THIS FORM.
Contact Employee Leaves and Workers' Compensation at 530-898-4670. If you have been denied FMLA leave, or exhausted your FMLA
leave for the 12-month period, you may complete this form to apply for a personal leave without pay.
Brief Description of Purpose (attach additional page if necessary):
A person requesting a leave of absence without pay is advised to become fully aware of the conditions of the leave. More information
concerning service credit, retention and promotion, and other matters pertinent to such a leave are found in the Faculty Personnel
Policies and Procedures (FPPP) and the Agreement Between the Board of Trustees of the California State University and the California
Faculty Association (CBA). The following key provisions are included here as a reminder to the applicant.
Professional Leave:
l Faculty unit employees shall be eligible to submit a written application for a leave of absence without pay. (CBA 22.1)
l Professional leaves are for purposes of research, advanced study, professional development, or other purposes of benefit to the
campus. (CBA 22.24)
l A Professional Leave of Absence Without Pay will count toward probation. It is the responsibility of the Dean and Department Chair
or Director to be certain that the retention/tenure evaluation will be sufficient to form the basis for a retention/tenure
recommendation even though the individual is absent for all or part of the academic year.
l If granted, the individual shall accrue service credit toward sabbatical eligibility, difference-in-pay eligibility, service salary increase
eligibility and seniority. Such accrual of service credit toward sabbatical eligibility and difference-in-pay eligibility shall be for a
maximum of one (1) year per sabbatical eligibility period. Such accrual of service credit toward service salary increase eligibility shall
be for a maximum of one (1) year per professional leave of absence without pay and extensions thereof. (CBA 22.25)
l Accrual of service credit shall be forfeited if conditions of the leave are not met. (CBA 22.25)
l Professional leaves must be followed by completion of the form "Request of Information Following Faculty Leave." The completed
form must be submitted to the department chair/director and dean no later than ten days after the beginning of the semester
following the leave.
l The leave of absence of a temporary faculty unit employee eligible for such leave pursuant to CBA Article 22 shall terminate upon
the expiration of that employee's temporary appointment. (CBA 22.27)
