Sabbatical Leave Application

Prior to submitting your application, please have a conversation with your dean and obtain their verbal approval. Your dean will provide documentation outlining the department plans for replacing your teaching schedule.

When you receive the verbal approval from your dean, complete this electronic form and click on the submit button. Once the application is submitted, your dean will receive an electronic copy, as confirmation of your submission.

Fields marked with an must be filled out to submit the form.

Contact Information

First Name

Last Name

Email

Office Phone

Only numbers, no dashes please

Job Information

Job Title

Department

Campus

Mail Codes

Mail Codes

Mail Codes

Valencia Identification Number (VID)

Dean/Supervisor Information

Dean Name

Provost/Vice President Information

Provost/VP

Term(s) of Requested Sabbatical Leave

Fall

Spring

Summer

Have you taken sabbatical leave before?

Yes

No

Award Criteria

All of the proposals which meet the Sabbatical Leave Policy’s purpose and criteria as listed in Policy 6Hx28:3D-12 will be ranked using the following criteria (in order of relative importance): a. Merit of the proposal b. Exceptional service to the College c. Number of prior Sabbatical Leaves approved and taken by the applicant (lower number receives greater priority) d. Number of years of applicable Valencia service

Type of proposal

Study

Research

Creative Work

Field Observation

Additional training for improving skills and for maintaining professional currency in the field

Other pursuits of value to the individual and the College

Provide a 2 to 3 sentence description of your sabbatical plans.

Required Attachments

Provide a detailed desciption of sabbatical leave proposal. Within the context of the proposal, include a: a. Description of your plan for sabbatical leave b. Description of how these activities will provide for individual renewal, learning and/or experience, which will enhance your ability to contribute to the college.

Description of your plan for sabbatical leave

Acceptable file types: .docx, .txt, .pdf. Maximum allowed file size: 10.00MB

A curriculum vitae and/or resume demonstrating exceptional service to the college.

Acceptable file types: .docx, .txt, .pdf. Maximum allowed file size: 10.00MB

Optional Attachments

If a proposal includes a request for college funds for activities such as travel, purchase of equipment or materials, or other related expenses, a budget must be attached to the application, which shall be separately considered by the college president or designee.

Budget

Acceptable file types: .docx, .txt, .pdf. Maximum allowed file size: 10.00MB

Letters of endorsement are encouraged.

Acceptable file types: .docx, .txt, .pdf. Maximum allowed file size: 10.00MB

Grant/Scholarships Anticipated During Sabbatical Leave

Granted: Sources and Amounts

Applied for: Sources and Amounts

Agreement

By checking this box, I agree to the Terms of Use.

By providing my electronic signature to this application I acknowledge that my proposal has been discussed and approved by my dean. I understand that my provost/vice president will have final approval before my application is reviewed by the committee. If granted sabbatical leave, I agree to abide by the terms of the Valencia College sabbatical leave policy, and within four months following completion of the sabbatical leave, submit a report summarizing the benefits and/or achievements resulting from the sabbatical leave. I understand that any travel conducted while on sabbatical is at my own risk. I understand that while employee health insurance benefits may continue while I am conducting research, study or work internationally, Valencia College shall not be responsible for the payment of emergency expenses incurred should I experience illness, accident, or injury during the period of sabbatical leave. If my leave includes travel, it is recommended that I purchase additional medical/trip insurance at my own expense, to cover unanticipated travel issues.