Faculty Development Leave Request

Apportionment (must total 100 in each column)*

	Current Apportionment	Requested Apportionment (during leave)
Teaching
Research
Service
Administration

Project Statement

Please upload a project statement (maximum of three pages), that includes:
- Description of the proposed project
- Updated report on the activities and accomplishments from any previous paid leaves
- Description of the work to be undertaken during the proposed leave
- Explanation of benefits of the proposed leave to the University and to the faculty member
Project Title: *
Project Statement*

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Previous Leaves

Please describe all previous leaves you have taken, including the dates of the leave(s), type(s) of leave and if the leave was with pay. If you have not taken any previous leaves, put N/A.
Description of previous leaves *
Appointment with Associate Dean for Research and Faculty Affairs

After you submit, please schedule an appointment with the associate dean for research and faculty affairs to discuss your proposal.
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