SABBATICAL LEAVE REPORT
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Rev 9/2/2015
Name: ___________________________________________ 89#: _____________________________
Department: ______________________________________
Purpose & Requirements:
Per Policy Statement 12, a petition for granting sabbatical leave is the result that the study and research will
enable a faculty member to increase their professional efficiency and usefulness to the University. A condition
for the granting of sabbatical is the potential benefit the university will receive as a result of the sabbatical.
Adequate justification setting forth the plans for each sabbatical leave is required, and a report of the
accomplishments toward those plans must be made by the first day of classes upon the semester of return from
sabbatical leave. The chair has two weeks to review, approve, and forward the report to the dean. Subsequently,
the dean has two weeks to review, approve, and forward the report to the Vice President of Research and
Economic Development.
I. Original Sabbatical Leave Goals:
In the box below, list the original goals of your sabbatical leave as stated in your approved proposal.
*Note: You may cut and paste your original goals/objectives from your approved sabbatical leave request.
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II. Progress toward Sabbatical Leave Goals:
In the box below, provide a description of your progress toward your original sabbatical leave goals and identify
whether or not each goal was accomplished.
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III. Benefit of Sabbatical Leave to LSU:
In the box below, describe how your sabbatical achievements benefit LSU.
Signed: _____________________________________________
Faculty Member Date
Approved: _____________________________________________
Department Chairman/Department Head Date
*My signature indicates that I have reviewed this report and agree that the original sabbatical
goals have been met.
Approved: _____________________________________________
Dean/Director Date
Approved: _____________________________________________
Kalliat T. Valsaraj Date
Vice President of Research & Economic Development
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