Fillable Part I Sabbatical Leave Report Signature Page (MiraCosta College)

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Part I Sabbatical Leave Report Signature Page (MiraCosta College)

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Part I
Sabbatical Leave Report – Signature Page
(to be completed upon return from sabbatical leave and submitted with your report)
Attached is my comprehensive Sabbatical Leave Report. I certify that I have fulfilled the
objectives of my sabbatical leave and will render the amount of service required by District
Policy – Administrative Procedure AP7341.
NAME: DEPARTMENT:
DATE SUBMITTED:
ACADEMIC SCHOOL YEAR IN WHICH LEAVE WAS TAKEN:
SEMESTER IN WHICH SABBATICAL LEAVE WAS TAKEN:
(NOTE: If this was a full-year leave or a variable leave, please indicate this. Do not include any unbanking as
part of a sabbatical leave)
CHECK (X) TYPE OF SABBATICAL LEAVE: Advanced Academic Studies, or
Self-directed studies
SIGNATURE:
(hard copy must include your actual signature on line above)
Applicant should not write below this line.
APPROVALS
Title
Approved
(Y/N)
Signature
Date
SLC Chair
Academic Senate
President
Superintendent/
President
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Part I Sabbatical Leave Report Signature Page (MiraCosta College)

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Completed 5 September 2020

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