Rev 10/1/2015
*Please arrange and submit each Sabbatical Leave Request packet in the order listed below.
*Packets must be assembled in this order prior to submission to HRM.
Packet Item
Note(s) / Reminder(s)
1. Sabbatical Leave Request form (pg. 1)
Ensure that “Campus Split”, other
campus, and percentages of campus split
are indicated in the top right corner of the
document (if applicable).
Check to make sure all information is
2. Evaluation by Chair/Department Head (pg. 2)
Ensure that chair/department head’s
signature is included.
3. Evaluation by Dean/Director (pg. 3)
Ensure that dean/director’s signature is
4. Signature page (pg. 4)
Ensure that the signatures of the
chair/department head and dean/director
are included.
5. Faculty member’s written request for Sabbatical Leave
Ensure that numbers 1-11 of the
Checklist for Sabbatical Leave Request
are complete (see Instructions for
Sabbatical Leave Request for reference).
6. Letter(s) of invitation or any relevant correspondence from
outside institutions.
7. Candidate’s C.V.
History of Assignments provided first (see
PS36-T Supporting Documentation for
8. Supporting Material (if applicable)
Such material shall only include documentation
that is directly related to the sabbatical leave
being requested, for example:
Documentation that cost of leave is
supported by outside funding source (if
Approved grant application (if applicable)
Please contact Nikki McNamara by email at or by phone at (225) 578-6623 with any questions.