Pacific Lutheran University
Sabbatical Leave*
Request Form for Academic Year 2010-2011
(due Monday, December 15, 2008)

Department/School				Name
1. (a) Period of Requested Leave				(b) If period is less than full year, circle the number of courses you plan to teach each term:
	[	] Full academic year, 2010-2011
	[	] Fall semester, 2010	[		] Fall: 2 3
	[	] Fall semester and January term, 2010-2011	[		] January Term: 1
	[	] January term and spring semester 2011	[		] Spring: 2 3
	[	] Spring semester, 2011
	[	] Other ______________________________
	2. Indicate, as specifically as possible, your plan for use of the sabbatical, both in regard to professional growth and development in regard to benefit for the university, school, and/or department. Please limit yourself to the space available on the reverse of this form.
	3. If development of plan or length of leave depends on additional funding (from external sources), state reasons and possible sources. Also, indicate date by which you will know whether such funding is available.

	Signature Date
* For Policies and Procedures, see 2003 Faculty Handbook, pp. 115 (see statement below)

Statement

[Faculty Handbook, p. 115, A. 5: Faculty members who are eligible for sabbatical and wish to request the opportunity must ordinarily file initial application, which includes a description of the intended activities, with the provost no later than December 15th of the second year preceding the school year during which the sabbatical is desired. Copies of the application should be submitted to one's departmental chair and divisional or school dean. The provost, in light of the criteria listed in Section D, and of recommendations of the other academic administrators involved and of the Faculty Committee on Rank and Tenure, will issue provisional approval or will defer or deny the request. In the case of a denial, appeal may be made to the president.] [Faculty Handbook, p. 115, A. 6: By October 15th of the year preceding the requested sabbatical, those faculty members who received provisional approval should provide the above administrators* with as nearly finalized plans for the requested sabbatical as possible. Recommendations for or against final approval will then be made by the provost to the president. Those sabbatical requests endorsed by the president will then be submitted to the Board of Regents for final action. If sabbatical plans are changed significantly from those approved by the board, reapproval by the provost and president must be obtained.]

*C: Department Chair
Divisional Dean
Provost
Rank and Tenure Committee (c/o Provost’s Office)

Office of the Provost
July 2006