POST-SABBATICAL LEAVE REPORT

Before completing this report please review the Sabbatical Leave Policy. Attach all relevant material (sample publications/chapters, evidence of professional development activities, or copies of transcripts/credentials) to this report. This report and relevant material should be submitted electronically within 90 calendar days of returning to campus. The approval sequence is as follows:

1.	College Dean

2.	Provost/Vice President for Academic Affairs

3.	Sabbatical Review Committee

4.	University President

Name:	Click here to enter text.

Position/Title:	Click here to enter text.

College/Department:	Click here to enter text.

Sabbatical Leave:	☐Full academic year	☐Fall 20____	☐Spring 20___

(Fall 20____and Spr20___)

Achievements resulting from sabbatical

(Describe what you have accomplished during your sabbatical leave)

Click here to enter text.

Benefits to the Faculty Member:

(Outline the ways in which the leave has benefited you professional and personally)

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Benefits to the University:

(Outline ways in which your leave has benefited the University)

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Identification of agencies/companies/individuals/institutions with whom the applicant collaborated while on sabbatical leave:

(Be as specific as possible about the nature of the collaboration)

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Expected follow-up:

(Identify any follow-up activities, study, or research that may result from your leave)

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Expenses incurred from the sabbatical leave activity:

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________________________________________________________	________________________________________

Signature of Faculty Member	Date

This sabbatical leave report has been reviewed and:

Meets expected outcomes	Meets expected outcomes

Does not meet expected outcomes	Does not meet expected outcomes

Report returned to faculty member	Report returned to faculty member

for revisions (reviewer should provide	for revisions (reviewer should

written feedback)	provide written feedback)

_________________________________________________	________________________________________________

Signature of College Dean	Date	Signature of Provost/VPAA	Date

Meets expected outcomes	Meets expected outcomes

Does not meet expected outcomes	Does not meet expected outcomes

Report returned to faculty member	Report returned to faculty member

for revisions (reviewer should provide	for revisions (reviewer should	written feedback)	provide written feedback)

_____________________________________________________________	_______________________________________________

Signature of Sabbatical Committee Chair	Date	Signature of University President	Date