Fillable Oapl-request-loa-withpayv6 Request for Change in Leave of Absence With Pay for Faculty

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Oapl-request-loa-withpayv6 Request for Change in Leave of Absence With Pay for Faculty

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OALP-Request-LOA-WithPay.pdf | Rev. 03/01/2018
Page 1 of 2
Kendall Hall Room 104
400 W. 1st Street
Chico, CA 95929-0024
530-898-5029
FAX: 530-898-4438
Office of Academic Personnel
CALIFORNIA STATE
UNIVERSITY CHICO
Request for Change
in Leave of Absence
With Pay for Faculty
This form must be completed by those wishing to request a change in their leave plans (either the type of leave or their leave
period.)
Name
College:
Dept/School
Sabbatical/DIP Leave Originally Awarded:
Academic Year:
One Semester Full Pay
AY 1/2 Pay
DIP
Type of Leave:
Change Requested*:
*NOTE: It is not possible to change from an AY 1/2 pay sabbatical or DIP TO a one-semester full-pay sabbatical, as one-semester
full-pay sabbaticals are ranked, and they have a fall deadline.
FPPP 13.1.2.d.3
If a faculty member's leave plans change before the start of the leave, these changes shall be submitted to the College Faculty
Leaves committee for evaluation. Should these changes not meet with the approval of the Committee, the leave shall be
rescinded/denied.
Leaves with pay are subject to (a) completion of a Promissory Note, to be submitted to the College Dean within 30 days of leave
approval, and (b) compliance with the Collective Bargaining Agreement between the California Faculty Association and the
Trustees of the California State University as well as University policy.
Approval must be secured from the University President in order to work for compensation on a sponsored project during the
sabbatical, difference in pay leave, or other leave of absence with pay.
Applicant Signature
Date
RECOMMENDATION OF DEPARTMENT CHAIR / DIRECTOR:
Having reviewed the applicant's proposed change in leave plans for his/her sabbatical or DIP leave of
absence, I recommend approval.
Yes
No
Department Chair / Director
Date
(Chair/Director: Please attach comments for a recommendation of non approval.)
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OALP-Request-LOA-WithPay.pdf | Rev. 03/01/2018
Page 2 of 2
RECOMMENDATION OF COLLEGE/UNIT LEAVES COMMITTEE:
Having reviewed the applicant's proposed change in leave plans for his/her sabbatical or DIP leave of
absence, I recommend approval.
Yes
No
College/Unit Leaves Committee Chair
Date
(Leaves Committee: Please attach comments for a recommendation of non approval.)
RECOMMENDATION OF DEAN/*VICE PRESIDENT FOR STUDENT AFFAIRS (*for counselors only)
I have reviewed the applicant's proposed change in leave plans for a sabbatical or DIP leave of absence,
along with the recommendations of the Department Chair/Director and the College/Unit Leaves
Committee. My recommendation is as follows:
Recommened
Not Recommended
Dean or
Vice President for Student Affairs*
Date
(College Dean/VP: Please attach comments for a recommendation of non approval.)
Approval of Change:
*(for counselors only)
DECISION OF PROVOST/*PRESIDENT (*for counselors only)
I have reviewed the applicant's proposed change in leave plans for a sabbatical or DIP leave of absence,
along with the recommendations of the Department Chair/Director, the College/Unit Leaves Committee
and the Dean/VP of Student Affairs.
Approved
Not Approved
Provost or
President
Date
Change in Proposed Leave Plan:
(for counselors only)
Reference: Unit 3 Collective Bargaining Agreement; California State University; CSU, Chico Faculty Personnel Policies and
Procedures; and Title 5 of the California Administrative Code.
ORIG: PAF/College
COPY: Faculty Affairs
Applicant
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Oapl-request-loa-withpayv6 Request for Change in Leave of Absence With Pay for Faculty

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Completed 26 November 2019

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