Draft 4/16/04
LEWIS-CLARK STATE COLLEGE
SABBATICAL RECOMMENDATION FORM

COVER SHEET
 

DATE:___________   NAME:_________________________________________________

DIVISION:________________________________________________________________

FACULTY RANK:__________________________________________________________

Indicate the nature of your request:

______  One year at half pay beginning ________________________________________
                                                                                      (date)

______  One half-year at half pay beginning _____________________________________
                                                                                      (date)

______  Other (please explain)_______________________________________________
                                                                                      (date)

LEWIS-CLARK STATE COLLEGE
SABBATICAL LEAVE REQUEST FORM
 

 DATE: _________________  NAME: ___________________________________________                                                                                           

DIVISION: ________________________   RANK: _______________________________

    I.   Purpose of sabbatical leave:  (Attach additional sheets as needed.)

   II.   How purpose is to be achieved:  (Including how extraordinary expenses will be covered.  Attach additional sheets as needed.)

III. Expected benefits:  (Proposal should indicate linkages among contribution to the faculty, division, college, and profession.  (Attach additional sheets as needed.)

A.How will your sabbatical benefit your personal renewal?

  B. How will your sabbatical benefit students and teaching?

C.How will your sabbatical benefit your scholarly/creative activity and professional development?

D.How will your sabbatical benefit your profession and division?

F. Does your proposal include a prestigious award, such as a Fulbright? Please explain.

IV.   Additional Information:

A.    Number of years served as full-time faculty member or number of years since last sabbatical leave at this institution:

FROM:________________   TO:________________
             (month) (year)                        (month) (year)

TOTAL YEARS __________

 B.   If you have received sabbatical leave in the past from this institution, indicate purpose and time:

 C.   If you expect to engage in any money-earning activities during the time of your sabbatical, please explain:

Attach a current vita to this application and submit three (3) 8 copies to the chair of the Faculty Development Committee.  Submit one (1) each to your division chair and dean.

 REVISED 5/03