ࡱ> %` "MbjbjNN n,,4Pd8P# 00000 <T"""""""$a$h&8#]40044#00e#4 00"4"0 s;{> D{#0#'H''4444444##444#4444PPPPPPPPP  APPLICATION for SABBATICAL LEAVE In recognition of meritorious service, continuing members of the academic faculty may, upon recommendation of the Chancellor and approval of the Board of Trustees, be granted sabbatical leave for purposes of scholarly activity and study which contribute to the professional growth of the faculty member and, thereby, to the continuing academic vitality of the University. Applicants should consult the Sabbatical Leave Policy, Personnel Policies, SIUE, II 6-7b of the most current Faculty Handbook, for details about faculty eligibility and length of leaves. During the period of sabbatical leave, a faculty member shall not engage in salaried work for another employer without prior approval of the Provost and Vice Chancellor for Academic Affairs or the Chancellor. By acceptance of a grant of sabbatical leave, a faculty member agrees to return to the University for a period of service of not less than the duration of the leave following termination of such leave. The faculty member also agrees to submit a report of sabbatical leave activity to the Provost through the Department Chair and School or College Dean within 90 days of return to regular assignment.Action on this application shall be based on information submitted on this form and on the applicant's responses to the questions in the Sabbatical Application Guidelines. Should conditions relating to the sabbatical leave change, an amended application must be submitted for review. Applications should be in the hands of the Provost by November 1, preceding the academic year in which the leave is to occur.Name: FORMTEXT      Soc. Sec. No: FORMTEXT      Banner ID: FORMTEXT      Rank: FORMTEXT      Department: FORMTEXT      AIS Account Title: FORMTEXT      Budget Purpose: FORMTEXT      Period for which sabbatical leave is requested (provide beginning and ending dates on appropriate line): FORMCHECKBOX  One (1) semester at full pay:  FORMTEXT      Semester, (yr.) FORMTEXT      FORMCHECKBOX  One year (12 months) at half pay, beginning FORMTEXT      Semester, (yr.) FORMTEXT      FORMCHECKBOX  One semester at half pay: FORMTEXT      Semester, (yr.) FORMTEXT      FORMCHECKBOX  Other: at  FORMCHECKBOX  half pay OR  FORMCHECKBOX  full pay; beginning on  FORMTEXT      , (yr.) FORMTEXT     and ending on  FORMTEXT      , (yr.) FORMTEXT     (These dates must fall within the academic year unless a different basic appointment period prevails. Ordinarily summer assignments are not part of the basic appointment period.)Purpose for which sabbatical leave is requested (include location):Purpose: FORMTEXT      Location: FORMTEXT    ')*+,-  L M m 0@DFӸĬӠӠ}q[}+j h#h!8CJOJQJU^Jh#CJOJQJ^Jjh#CJOJQJU^J%h5B* CJOJQJ\^JphhNCJOJQJ^JhCJOJQJ^Jh|rCJOJQJ^Jhh$CJOJQJ^Jh$CJOJQJ^Jh$5OJQJ\^J h$CJjh$CJUhZ!'()*Skde$$IfTl40 {*`w p *4 laf4T $$Ifa$gd $Ifgd "M*+,-. c^gd$>kdI$$IfTl4{***4 laf4T $IfgdSkd$$IfTl40 {* w p *4 laf4T togd$@kd$$IfTl4%{***4 laf4T $Ifgd@kd$$IfTl4C{***4 laf4T:Px $Ifgd@kd^ $$IfTl4h{***4 laf4T(*,68:PRfhjtvxzλ΅p`T>``8 hCJ+j hB!h!8CJOJQJU^JhB!CJOJQJ^JjhB!CJOJQJU^J(hh5B* CJOJQJ^Jph%j hCJOJQJU^JjhCJOJQJU^J%h5B* CJOJQJ\^Jph%h#5B* CJOJQJ\^JphhCJOJQJ^Jjh#CJOJQJU^J*jhSwCJOJQJU^JmHnHuxz_VVVM $IfgdZ $Ifgdkd#$$IfTl4ֈf\H ${*r8*4 laf4Tz,кܤЎܤЈubRFhyCJOJQJ^JjhyCJOJQJU^J%h$5B* CJOJQJ\^Jph%h B5B* CJOJQJ\^Jph h"0CJ+j h#h"0CJOJQJU^J*jhSwCJOJQJU^JmHnHu+j4hyh"0CJOJQJU^Jh"0CJOJQJ^Jjh"0CJOJQJU^J%h"05B* CJOJQJ\^Jph>^|||| $Ifgdykd$$IfTl4\fL*:*/4 laf4T,.0:<>\^`tvxZ\^zٷu_ÁYIY9jh$CJOJQJU^JhB!h$5CJOJQJ^J h$CJ+j]h#h!8CJOJQJU^Jh#CJOJQJ^Jjh#CJOJQJU^J%h$5B* CJOJQJ\^Jph%h5B* CJOJQJ\^Jphh$CJOJQJ^J*jhSwCJOJQJU^JmHnHujhyCJOJQJU^J+jhyhyCJOJQJU^JZ\|;|||@kd$$IfTl4h{***4 laf4T $Ifgdykd$$IfTl4\,"{*T*4 laf4Tz|~  "*,024PRTͺ٤͑٤͋ub٤%jh$CJOJQJU^J+jhhSwhSwCJOJQJU^J h$CJ%jh$CJOJQJU^J*jhSwCJOJQJU^JmHnHu%jh$CJOJQJU^Jh$CJOJQJ^Jjh$CJOJQJU^J+jhSwhSwCJOJQJU^J .02 ikdm$$IfTl4rn $H{*  3 *4 laf4T $Ifgd "$@BD|~ ,.Jܺܺܺܺܺܺxܺܺbܺܺ+j>#hSwhSwCJOJQJU^J%j h$CJOJQJU^J%jmh$CJOJQJU^J+jhSwhSwCJOJQJU^J h$CJh$CJOJQJ^J*jhSwCJOJQJU^JmHnHujh$CJOJQJU^J%j`h$CJOJQJU^J! "|riiiii $Ifgdkd$$IfTl4r$H{*l$3 *4 laf4T<dtriiiiiiii $IfgdkdC"$$IfTl4r$H{*& j 3 *4 laf4T JLNln<>RTV`ͷͧo\oͧFo+j'h#h!8CJOJQJU^J%jL&h$CJOJQJU^J*jhSwCJOJQJU^JmHnHu+j$h#h!8CJOJQJU^Jh#CJOJQJ^Jjh#CJOJQJU^J+j&$hSwhSwCJOJQJU^Jh$CJOJQJ^Jjh$CJOJQJU^J+j#hSwhSwCJOJQJU^J`btvӪ㤔xbxL+j.hyhyCJOJQJU^J+j-hyhyCJOJQJU^JhyCJOJQJ^JjhyCJOJQJU^JhB!h$5CJOJQJ^J h$CJ*jhSwCJOJQJU^JmHnHu%jL)h$CJOJQJU^Jjh$CJOJQJU^Jh$CJOJQJ^Jjh#CJOJQJU^J90 $Ifgdkd*$$IfTl4ִb4%'{*Fvv*    4 laf4Tt@kd,$$IfTl4{***4 laf4T $Ifgd@kd?,$$IfTl4P{***4 laf4TD D DEENSkd/$$IfTl40{*a'*4 laf4T $IfgdSkd+.$$IfTl40{*a'*4 laf4T   A summary of not more than 25 words must appear here. This statement will be used to report the request for leave to the Board of Trustees. (Attach responses to questions in the Sabbatical Application Guidelines.)  FORMTEXT      Amount of salaried income expected from another employer: FORMTEXT      Amount of non-University income expected from grants, scholarships, or other sources: FORMTEXT      Amount of travel and/or living expenses expected from grants, scholarships, or other sources:  FORMTEXT      Number of years of service: FORMTEXT      Dates of same: FORMTEXT      Previous leaves with or without pay (give dates): FORMTEXT      Please sign and make a file copy before forwarding. Signature of applicantDate Leave recommended by Chairperson: Date Dean: DateApproved by:Provost and Vice Chancellor: DateChancellor: DateRatified by the Board of Trustees at their meeting of , (yr.) 4/08 DDDD D DvDvEEEEEEEEEEEZF\FpFrFtF~FFFF0G2G˶˪˚ˇŶ{eŶUjh!8CJOJQJU^J+jz2hyhyCJOJQJU^JhyCJOJQJ^J%j_0h$CJOJQJU^Jjh$CJOJQJU^JhCJOJQJ^JhB!h$CJOJQJ^J h$CJh$CJOJQJ^JjhyCJOJQJU^J*jhSwCJOJQJU^JmHnHuUEEZFFF0GXGaSkd3$$IfTl40{**4 laf4T $Ifgd@kd2$$IfTl4n{***4 laf4T2GFGHGJGTGVGXGZGHH0H2H4H>H@HBHDH|H~HHHHHHHHHθάθάkθΗ[OhyCJOJQJ^JjhyCJOJQJU^J+j8h!8h!8CJOJQJU^J+jr6h!8h!8CJOJQJU^JhB!h$CJOJQJ^J h$CJh$CJOJQJ^J*jhSwCJOJQJU^JmHnHujh!8CJOJQJU^J+jo4h!8h!8CJOJQJU^Jh!8CJOJQJ^JXGZGHBHDH|HHHHNSkdH8$$IfTl40{**4 laf4T $IfgdSkd5$$IfTl40{*R*4 laf4THHHHHHHPIRIfIhIjItIvIxIzIIIIJJ J"J$JzJ|J~JJJJJJٷٖٷp]QhCJOJQJ^J% *hB!h$5CJOJQJ\^J *h$5CJOJQJ\^J+j<hyhyCJOJQJU^JhyCJOJQJ^JhB!h$CJOJQJ^J h$CJh$CJOJQJ^J*jhSwCJOJQJU^JmHnHujhyCJOJQJU^J+j:hyhyCJOJQJU^JHHPIxIzI||(Skdx=$$IfTl40{*l{*4 laf4T $Ifgdykd7;$$IfTl4\` {**4 laf4TzIIIIJJ J"J $Ifgd@kd=$$IfTl4{***4 laf4T $$Ifa$gdB!"J$J&JjJlJnJxJzJ|p|||| $$Ifa$gd $IfgdykdV>$$IfTl4\\{*dd8 *4 laf4TzJ|J~JJJJJJ|p|||| $$Ifa$gd $Ifgdykd;?$$IfTl4\ \{*P x8 *4 laf4TJJJJJJ|;/| $$Ifa$gd@kd@$$IfTl4{***4 laf4T $Ifgdykd@$$IfTl4\ \{*P x8 *4 laf4TJJKKKKK K*K,K|p $$Ifa$gdykdTA$$IfTl4\ \{*P x8 *4 laf4T $Ifgd JKK,K.K6K8KKKMMMMMMM M"MhhB!CJOJQJ^Jh BCJOJQJ^Jh$5CJOJQJ\^J h$CJh$CJOJQJ^J,K.K0K2K4K6Kyppp $Ifgd $$Ifa$gdykd+B$$IfTl4\ \{*P x8 *4 laf4T6K8KKKKK|||| $IfgdykdC$$IfTl4\ \{*P x8 *4 laf4TKKMMM|;/ $$Ifa$gdgM@kdD$$IfTl4{***4 laf4T $IfgdykdC$$IfTl4\"{*z*4 laf4TM M"MgdZ>kdD$$IfTl4{***4 laf4T,&P/ =!h"h#$% / 0&P/ =!h"h#$% 5 0&P:pZ/ =!h"h#$% eDdT  C 0Alogo_150_btb%ǏnZPѧȂa\DFn%ǏnZPѧȂa\PNG  IHDR VtRNS["bKGD̿ cmPPJCmp0712`IDATXGXu8 oqsq3X ':A '8z>,;K{Ad ?b}E]CѓVVXAj䍏RzD5#vFZ>1JۨW;RNg]@%SHHIW3Owm0m^ZFQr u%|TjCn fW: ($7u #i*[EA0Z+~!4^__%h\y劶[lߕ'&_x&Zx j#/m;v7Ek+)|w؁ P֬.m27 CZ l)XYG7EktqpftװR[¢2' -*F'45U )= ғ*,X97peō`KPYxЄ4JO] q|"C%43pMѲ`UڮP;yKaG@^abbK^qKRԺ^Ye6[-Ϫ!<\ ]'CVAiiUڔ`fa2]!slj1d j  5![KK?_ǝT4YSu~q7de58)QKB`،trQ1i)8Hgה-x{~W[VBOq?0jn~ =尰10 .'CAX8^[TɿZ89ZI|ő-\“L's+0 '׿3fw)>Q!6˥3@p>7Hyn3o(NuS;j8yvt?Nv$w"HfD10kC=8? íYqɘP N];W=jTR=%}sM}×Eeԭr7bX-aLl3eܹjl'-m;-I7! Vo_$}S~Q37VQ,EU9xc~$3R/bR(A1.`JsJa"QQ\\:€#/Ҡ\B' |ÀΠ6̮Ф{Ttgw#r=vM*;ƺ}hglo/i?@ ; .1"+{kLI?xs\;>;lhE_fR!IENDB`p$$If!vh5w 5p #vw #vp :V l4*+5w 5p 4f4Tp$$If!vh5w 5p #vw #vp :V l4*+5w 5p 4f4TQ$$If!vh5*#v*:V l4*5*4f4TU$$If!vh5*#v*:V l4C*5*4f4Ti$$If!vh5*#v*:V l4%*,5*/ 4f4Ti$$If!vh5*#v*:V l4h*,5*/ 4f4T D7Text3;Enter the name of the person applying for sabbatical leave.Maximum field length is 50.D Text4;Enter the applicant's social security number (xxx-xx-xxxx).\Maximum field length is 11; no spaces are allowed before and after the dashes (xxx-xx-xxxx).D ;Enter the applicant's social security number (xxx-xx-xxxx).\Maximum field length is 11; no spaces are allowed before and after the dashes (xxx-xx-xxxx).$$If!vh55r55585#v#vr#v#v#v8#v:V l4*,55r55585/ / / / / 4f4TD2Enter the applicant's rank.Maximum field length is 50.D#3Enter the applicant's employing unit or department.Maximum field length is 40.$$If!vh55:55#v#v:#v#v:V l4*/,55:55/ / / / 4f4TvDFText13eEnter the name of the account the applicant is to receive his or her salary from while on sabbatical.Maximum field length is 45.pDText5cEnter the account number to be charged for the applicant's salary while he or she is on sabbatical.Maximum field length is 10.$$If!vh555T5#v#v#vT#v:V l4*,555T5/ / / / 4f4Ti$$If!vh5*#v*:V l4h*,5*/ 4f4TtDeCheck1hDText6_Enter the name of the semester the applicant would like to take a sabbatical leave at full pay.Maximum field length is 20.D Text70lEnter the year associated with the semester the applicant would like to take a sabbatical leave at full pay.Maximum field length is 4.$$If!vh5 5 5553 #v #v #v#v#v3 :V l4*,5 5 5553 / / / / / 4f4TtDeCheck2DrEnter the name of the semester the applicant would like to begin his or her 12 month sabbatical leave at half pay.Maximum field length is 20.D 0Enter the year associated with the semester the applicant would like to begin his or her 12 month sabbatical leave at half pay.Maximum field length is 4.$$If!vh5l5$5553 #vl#v$#v#v#v3 :V l4*,5l5$5553 / / / / / 4f4TtDeCheck3^D_Enter the name of the semester the applicant would like to take a sabbatical leave at half pay.Maximum field length is 20.xD 0lEnter the year associated with the semester the applicant would like to take a sabbatical leave at half pay.Maximum field length is 4.$$If!vh5& 5j 5553 #v& #vj #v#v#v3 :V l4*,5& 5j 5553 / / / / / 4f4TtDeCheck4tDeCheck5tDeCheck6D Text8Enter the date the applicant would like to begin his or her sabbatical if the time period is other than one of the above selections.Maximum field length is 10.D Text90Enter the year associated with the beginning date of the other time period the applicant would like to take a sabbatical leave.Maximum field length is 4.XD \Enter the ending date of the other time period the applicant is requesting sabbatical leave.Maximum field length is 10.D 0vEnter the year associated with the ending date for the other time period the applicant is requesting sabbatical leave.Maximum field length is 4.e$$If!vh55F5v5555v5#v#vF#vv#v#v#v#vv#v:V l4*,55F5v5555v5/ / / / / / / / 4f4Ti$$If!vh5*#v*:V l4P*,5*/ 4f4Ti$$If!vh5*#v*:V l4*,5*/ 4f4TDxText104Enter the purpose of the requested sabbatical leave.Maximum field length is 100.$$If!vh55a'#v#va':V l4*,55a'/ / 4f4TDxText104Enter the purpose of the requested sabbatical leave.Maximum field length is 100.$$If!vh55a'#v#va':V l4*,55a'/ / 4f4TDText1Enter a short summary of the purpose for requesting the sabbatical leave. This information will be used for Board of Trustee review.Maximum field length is 450.c$$If!vh5*#v*:V l4n*5*/ 4f4TfDKText2^Enter the salary amount expected from other employers during the sabbatical leave time period.Maximum field length is 20.$$If!vh55#v#v:V l4*,55/ / 4f4TtD2jEnter amount of non-university income, such as from grants, the applicant may receive while on sabbatical.Maximum field length is 20.$$If!vh5R5#vR#v:V l4*,5R5/ / 4f4TD(Enter the amount of travel and living expenses that will be coverd from grants, scholarships, and/or other sources during the sabbatical leave time period.Maximum field length is 20.$$If!vh55#v#v:V l4*,55/ / 4f4T:DText11HEnter the number of years of service the applicant has provided to SIUE.Maximum field length is 5.&DKText12=Enter the dates of service the applicant has provide to SIUE.Maximum field length is 45.$$If!vh5555#v#v#v#v:V l4*,5555/ / / / 4f4TjDUText14_Enter the dates for and types of leaves the applicant has previously taken with or without pay.Maximum field length is 70.q$$If!vh5l5{#vl#v{:V l4*,5l5{4f4Ti$$If!vh5*#v*:V l4*,5*/ 4f4T$$If!vh5d5d585 #vd#vd#v8#v :V l4*,5d5d585 / / / / / 4f4T$$If!vh5P 5x585 #vP #vx#v8#v :V l4*,5P 5x585 / / / / 4f4T$$If!vh5P 5x585 #vP #vx#v8#v :V l4*,5P 5x585 / / / / 4f4Ti$$If!vh5*#v*:V l4*,5*/ 4f4T$$If!vh5P 5x585 #vP #vx#v8#v :V l4*,5P 5x585 / / / / 4f4T$$If!vh5P 5x585 #vP #vx#v8#v :V l4*,5P 5x585 / / / / 4f4T$$If!vh5P 5x585 #vP #vx#v8#v :V l4*,5P 5x585 / / / 4f4T$$If!vh5z555#vz#v#v#v:V l4*,5z555/ / 4f4T[$$If!vh5*#v*:V l4*,5*4f4TW$$If!vh5*#v*:V l4*,5*4f4T8@8 $Normal_HmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No List6U@6 $ Hyperlink >*B*phFV@F FollowedHyperlink >*B* ph.n.n_n'()*+,-.`ag{ /CDXl|` t |    - A B ! 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R? n!hr4d2QHP ?gM* OITOITOh+'0|   , 8 D P\dlt OITsabbaticalappOIT2Microsoft Office Word@@@.};{@.};{R? ՜.+,0 hp  SIUE'  Title  !"#$%&'()*+,-./012345679:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ\]^_`abcdefghijklmnpqrstuvxyz{|}~Root Entry Fpz;{Data 8