Thisapplication meets UPS 260.102 and Unit 3 CBA Article 27 guidelines. Applicants are urged to read both thoroughly prior to completing this application. An application consists of this form and, if applicable, a statement of economic interest form. The completed application must be emailed as an attachment to Linda Ramirez () by the deadline of5:00 p.m. on Wednesday, October 15, 2014.
Should you have any questions or need assistance, please contact Linda Ramirez at or by phone at 657-278-2879. Please note, only completed applications submitted by the deadlineby faculty who are eligible for a sabbatical leave in 2015-2016 will be considered by the Professional Leaves Committee.
SECTION 1: APPLICATION INFORMATIONCWID / / Name /
Department /
College /
Sabbatical Term Requested: / Click to select a term /
Proposal Title: /
Proposal Description Please provide a concise description (75 word maximum) of your proposal in the space provided below. If a leave is granted, this description will be provided to Strategic Communications at CSUF for announcements.
Will any CSU resources other than your salary be necessary to carry out this project?
If you answered yes, please specify here:
Do you have any financial interest involved with the project or enterprise you will undertake while on leave?
Please complete and also submit a Statement of Economic Interest form.
Proposal Work Product(s)Please specify the work product(s) expected to result from the sabbatical leave (e.g., development of a degree proposal, publication or a research article or book, composition of a musical score).
Insert your proposal work product(s) here:
SECTION 2: APPLICATION NARRATIVE
Please provide a description of the plan for research, scholarly or creative activity, instructional improvement, or faculty retraining, as well as an indication of your readiness to undertake this project (as evidenced by past performance, preliminary research in preparation for the project, etc.). Plans for travel, study, research, and professional development (including retraining) must be detailed in the proposal.
This application narrative proposal is not to exceed five pages. Insert your narrative here:
SECTION 3: PRIOR SABBATICAL
Have you received a sabbatical leave in prior years while at CSUF?
Please include a brief summary of the outcomes of the most recent prior sabbatical leave; if the proposed
project was not ultimately completed, please indicate why and provide the Professional Leaves Committee
with a rationale consistent with the likelihood that the proposed project will come to fruition. This
appendixto the proposal narrative is not counted against the five-page proposal limit.
This brief summary should be one page or less. Insert your brief summary here:
SECTION 4: CURRICULUM VITAE
Please provide a curriculum vitae which is focused on activities relevant to the sabbatical project. (For example, if the project is to develop further one’s pedagogical skills, the curriculum vitae shall reference recent teaching or professional activities related to the proposed project.)
This curriculum vitae is not to exceed two pages. Insert your curriculum vitae here:
SECTION 5: APPLICANT SIGNATURE
I recognize that this leave, if granted, will be pursuant to Article 27 of the Faculty Collective Bargaining Agreement and the CSUF Sabbatical Leaves Policy. I agree to abide by the terms of the Faculty Collective Bargaining Agreement and CSUF policies and procedures referred to therein should this application be approved.
If this leave is granted, I agree to return to the service of the California State University and render at least one term of service for each term of leave. Pursuant to the requirements of Article 27.9 of the Faculty Collective Bargaining Agreement, I agree to sign a promissory note (the value of which is at least equal to the amount of salary to be paid during the sabbatical leave) as evidence of my capacity to indemnify the State of California againstloss in the event of failure to fulfill this agreement.
Note: Those individuals approved for sabbatical leaves will be asked to sign a promissory note after the President's decision has been announced. The State will pursue repayment should any employee fail to return service.
Date / Clicktoselect date / ☐I declare under penalty of perjury that the portions of thisapplication I have completed are true and correct.
*Note: CBA Article 27.18 provides that a faculty unit employee on leave with pay shall NOT accept outside employment without approval of the President. This application does NOT secure such approval.A copy of this application will be provided to the Chair of yourdepartment.Pursuant to CBA Article 27.6, the department shall provide a statement regarding the possible effect of the leave on the curriculum and the operation of the department.
ADMINISTRATIVE USE ONLYDate Received: / Application ID:
Notes: