Part I
Sabbatical Leave Application Signature Page
Name: Department:
Application Submission Date:
Full-time Hire Date (semester and year):
Semester and year of last sabbatical leave
(or ‘NA’ if you have never taken a sabbatical leave):
Period of sabbatical leave requested:
• Academic School Year:
• Check (X) the length of Sabbatical Leave:
One semester (indicate semester of preference:
Or One-year at 50% compensation (do not include unbanking),
Or Variable (approval of Superintendent/President required prior to submission of application).
Date of proposed return to full-time service (if unbanking):
Prior to submitting your application, perform the following steps:
Step 1: Notify your Department Chairperson (or equivalent) of your intent
to request a sabbatical leave, giving him/her the opportunity to consider
staffing, budgets, previous evaluations and other issues.
Step 2: Notify your Dean (or equivalent) of your intent to request
a sabbatical leave, giving him/her the opportunity to consider staffing,
budgets, previous evaluations and other issues.
Step 3: Notify your Vice President (or equivalent) of your intent to request
a sabbatical leave, giving him/her the opportunity to consider staffing,
budgets, previous evaluations, SLO assessment calendar, and other issues.
Step 4: Submit application & application (hard copy and electronic copy) to SLC Administrative Secretary prior to
deadline. SLC will review and make recommendations for revisions.
I understand that I must have six years of service prior to and between each sabbatical leave and
certify that the foregoing is correct and that I will complete the requisite number of hours (576)
in self-directed and/or academic studies:
Signature:
Original signature is required on hard copy:
APPROVALS (applicant should not write below this line)
President
Board of Trustees
President
