Please consult the procedures and policies governing FDLs before applying.

Applicant Information /

Name of applicant:

Academic rank:

Department:

College/School:

Date of initial hire at UT Tyler in fullt-time tenure-trackposition:

Date tenured: Date promoted: Date of next post-tenure review:

Eligibility / First time applicants: Faculty applying for FDL for the first time must have completed at least 6 consecutive years as a full-time faculty member at UT Tylerby the time FDL begins.
Subsequentapplications: Faculty applying for FDL for the second or subsequent time must have completed at least 6 consecutive years as full-time faculty at UT Tyler since the last FDL before a new FDL can begin.
Check one:
First application for FDL. Number of consecutive years completed in full-time faculty position at UT Tyler:
Second or subsequent application for FDL. Number of years since completion of last FDL:
List leaves longer than 3 months that you have had since the date of hire or since your return from the last FDL (include type of leave, inclusive dates of leave, and funding).
FDL Type /

Type of Faculty Development Leave

Academic year (one academic year at the rate of six (6) months salary; cannot cross academic years)
Semester (one semester at rates not to exceed one semester’s salary)
Dates of Proposed FDL: From to
List names and dates of foreign countries you intend to visit during theFDL(for risk management purposes):
List names and dates of locations you intend to visit during the FDL (for risk management purposes):
Other non-FDL funds and income anticipated:
FDL Plan /

Statement of Plan for Faculty Development Leave

Attach to this page an five-page outline of your plan for the FDL, including:
a)This cover page
b)Project summary (one page)
c)Project description (5 pages single-spaced; 12-point font; proposed activities, including proposed research plan, location(s) where proposed activities will take place), timeline for the project and benefits of the leave to your own goals and those of your department, college, and UT Tyler
d)Updated, full CV
e)Efforts to secure outside funding if that funding is relevant to this application.If leave is dependent upon award of outside funding, so indicate
f)If leave is dependent upon utilization of facilities of another institution, so indicate and attach copy of letter of invitation or authorization
Signature / Your signature below indicates that you are familiar with all obligations a faculty member has regarding a FDL, as described in the procedures and policies of FDL, and that you are willing to remain employed by UT Tyler for at least one year after the expiration of the term of your FDL unless this has been waived, in writing, by the President.
Signed: ______Date: ______

Recommendations

Chair / Approved Disapproved
Comments:
______
Signature of Chair Date
Dean
/ Dean: Provide comments and/or conditions of award OR reason for not approving.
Approved Disapproved
Comments:
______
Signature of Dean Date
Provost / Approved Disapproved
Comments:
______
Signature of Provost Date
President / Approved Disapproved
Comments:
______
Signature of President Date

Please Note: If the dates of leave, funding, activities or location(s) associated with your approvedFDL change, you MUST submit a written change of FDL leave plan memo to your Chair and/or Dean and the Provost for approval.

All outside funds to be used for FDL must be listed in the applicationand approved in advance of your leave, or you will not be able to apply them to your FDL costs or salary.

If you are approved to use outside funds for your FDL, please be sure to clearly document the details of your desired distribution of the funds with your grants office before you depart.

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