THE UNIVERSITY OF RHODE ISLAND
STAFF
REQUEST FOR SABBATICAL/EDUCATIONAL LEAVE
NAME _______________________________________ RANK/TITLE _______________________________
COLLEGE ____________________________________ DEPARTMENT _____________________________
LWOP __________________ EDUCATIONAL _____________________ FULL YEAR __________________
SABBATICAL ______________ Fall Semester ________________ Spring Semester _____________
Other ____________________________________________
Date of Initial Appointment: ______________________________________
Dates and Types of Previous Leaves: ________________________________________________________
________________________________________________________
________________________________________________________
Number of Years of Full Time Service at
URI: _____________
(partial years of service are not cumulative and cannot be counted)
ATTACH A STATEMENT WHICH INCLUDES THE FOLLOWING INFORMATION:
I.
Background for sabbatical/education leave proposal; specific intended outcomes
of leave activity (short term and long
term goals);
II. A specific
outline of the sabbatical/education leave proposal, including dates, location of
study, specific arrangements
for laboratory space,
studio space, or library facilities; and activities to be conducted;
III. Supporting materials:
Letters confirming support or agreement to cooperate; an evaluation of the
project if applicable;
a bibliography relevant
to the activity being prepared; and
IV. An updated resume limited to material related to the requested leave.
APPLICANTS SIGNATURE: ____________________________________________________
DATE: ________________________
APPLICANTS FOR LEAVES (six copies) SHOULD BE FORWARDED TO THE VICE PRESIDENT BY FEBRUARY 1 AND TO THE ASSISTANT VICE PRESIDENT FOR HUMAN RESOURCE ADMINISTRATION BY MARCH 1 OF THE ACADEMIC YEAR PRECEDING THE LEAVE.
The following section is to be completed by the Supervisor:
EVALUATION OF THE PROPOSAL (include its worth and contribution to the department as well as the individual's professional growth).
WILL A REPLACEMENT BE NECESSARY? YES _______________ NO _______________
HOW WILL THE PROFESSIONAL ASSIGNMENT OF THE APPLICANT BE CARRIED OUT DURING THE PERIOD OF LEAVE?
SUPERVISOR'S RECOMMENDATION _________________________________________________________
SUPERVISOR'S SIGNATURE ________________________________________________________
DATE _______________________________________________________
DEAN/DIRECTOR/S RECOMMENDATION _______________________________________________________
DATE _______________________________________________________
PROVOST'S RECOMMENDATION _______________________________________________________
PROVOST'S
SIGNATURE
_______________________________________________________
DATE
PRESIDENT'S
SIGNATURE
_______________________________________________________
DATE
HUMAN RESOURCE
ADMINISTRATION
_______________________________________________________
DATE
September 1984
November 1985 (revised)