Request for AWA and/or Overload

ESU Funded Alternate / Additional Work Assignment(AWA)request form is due in the Provost’s Officeno later than April 15 for Fall or entire academic year, and no later than October 1 for Spring. Alternate / Additional Work Assignmentrequests for NEW funded awards (i.e. Grant Funded, Self Supporting, etc.)can be submitted at any time during the year. Alternate / Additional Work Assignment (AWA) request for SUMMERare due in the Provost’s Officeno later than April 15. All other requests made after the deadline will be considered on a case-by-case basis.

Name:
Department:
College:
Period Requested: / Fall Semester / [] / Workload Units
Spring Semester / [] / Workload Units
Summer Term / [] / Workload Units
Group where activity/assignment is being performed:
PASSHE / [] / University / [] / College / [] / Department / []
New Request / Previous Request / /
If Yes, list semester / year / (Semester/Year)
Attach written report for previous awarded Alternative Assignment.
Does this result in Overload for the requestor? / [] Overload for course or assignments as per Article 25: Overload of the CBA.

Describe in detail the project(s), assignment or class. (Attach any documentation to form as needed.)

Source of Funding for Release(check all appropriate boxes)

University
Grant Funded? / Fund Center
Self Supporting Account? / Fund Center
Other Funding Source? / Fund Center

Upon completion of this assignment, I shall submit a detailed written report of my activities to the Chair, Dean, Provost and President

Requestor’s Signature / Advisor Number / Date

Signatures and Approvals

Requests that involve 2 or more departments and/or colleges require signatures from all involved.
/

Workload Units

Recommendation

Department Chair’s Signature(s) / Date

/

Fall

/

Spring

/

Summer

Dean’s Signature(s) / Date

/

Fall

/

Spring

/

Summer

Provost’s Signature / Date

/

Fall

/

Spring

/

Summer

ACTION:

/

Workload Units Approved

President’s Signature / Date

/

Fall

/

Spring

/

Summer

Original: Registrar

Copies: Provost Institutional Research & Assessment Dean Chair Faculty Member

C:\Forms\Overload & Reassigned Forms\Non-Contractual Form.doc –Rev March 2014