Sabbatical Leave Application Form

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.

ACKNOWLEDGEMENTS

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 Valencia’s 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.

APPLICANT INFORMATION

First Name*

Last Name*

VID Number*

Job Title*

Department*

Campus*

Mail Code*

Email*

Office Phone*

Only numbers, no dashes please

DEAN/SUPERVISOR INFORMATION

Dean First Name*

Dean Last Name*

Dean Email*

example@example.com

PROVOST/VICE PRESIDENT INFORMATION

Provost/VP First Name*

Provost/VP Last Name*

Term(s) of Requested Sabbatical Leave*

Fall 2025Spring 2026Summer 2026

Have you taken Sabbatical Leave before?*

YesNo

Start Date of your previous Sabbatical Leave*

Date

End Date of your previous Sabbatical Leave*

Date

AWARD CRITERIAAll 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*

StudyResearchCreative WorkField ObservationAdditional training for improving skills and for maintaining professional currency in the fieldOther pursuits of value to the individual and the College

If Other, please give details*

Provide a 2-3 sentence description of your Sabbatical Plans*

REQUIRED ATTACHMENTS

1. A typed, 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.

*

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

*

OPTIONAL ATTACHMENTS

1. Letters of endorsement are encouraged.

Select File

2. 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.

GRANTS/SCHOLARSHIPS ANTICIPATED DURING SABBATICAL LEAVE

Granted: Sources and Amounts

Applied for: Sources and Amounts

Electronic signature (Your Name)*