Faculty's Comments addressing how additional employment affects the approved leave, and how the leave project
will be accomplished if applicable (attach copy of approved leave proposal).
Name of organization where
additional employment is sought:
Is additional employment with pay?
If yes, amount of remuneration:
List the specific activities for which you will be paid.
If teaching where will you teach? What courses will you teach? How many courses will you teach? Other activities not previously listed:
Amount of time per week:
Name of Supervisor:
Telephone number of
Supervisor (with area code):
Is tenure another institution involved?
List all other information that may be pertinent below (attach additional page if necessary); i.e. will employment
potentially affect any existing contracts, grants, or agreements with the University or its affiliates.
Chair's comments (attach additional pages if more space is needed)
Chair's Signature (forward form to Dean):
Dean's comments (attach additional pages if more space is needed)
Dean's Signature (forward form to Human Resources - CP-700):
Provost's comments (attach additional pages if more space is needed)
Guidelines for Sabbaticals can be found at
Guidelines for Difference-In-Pay Leaves can be found at