Office of the Provost 4.19.13

Application for Professional Leave

(Note: Effective Fall 2011, faculty professional leave applications will be submitted electronically. Please contact your college dean’s office for application submission information specific to your college.)

Applicant / Click here to enter text. / Rank / Click here to enter text.
Department / Click here to enter text. / Date of initial WWU service / Click here to enter text.
Date and duration of previous professional leave(s) / Click here to enter text. / Years of full-time service since previous paid professional leave / Click here to enter text.
Numbers of quarters of leave requested, and dates of those quarters / Click here to enter text. / Applicant W# / Click here to enter text.
Purpose of professional leave (please check one):
☐For research or to participate in other creative endeavor.
☐Study program designed to improve teaching techniques.

For a complete statement on Professional Leave, see Section 10 of the Collective Bargaining Agreement.

Include the following material to this application as numbered appendices (copy and paste as appropriate):

Appendix 1: Detailed statement of plans for utilizing time requested

Appendix 2: Detailed description of how proposed activities contribute to area of study, professional development, and contributions to the university.

Appendix 3: Names of institutions and individuals with which the applicant will be associated, with pertinent itineraries and specific dates.

Appendix 4: A statement of any time to be spent on other duties and any compensation to be received.

Appendix 5: A current vita.

Appendix 6: In cases where technical support is required for the project, a statement of support costs and how these will be met.

Appendix 7: Additional material in support of the proposed program, such as examples of applicant’s work.

Appendix 8: Copies of reports of previous professional leaves and reports of summer research or teaching grants, or faculty development grants from previous three years. Include descriptions of pending applications for summer research or teaching grants or faculty development grants.

Please forward via email this application to your chairperson after completion.

Appendix 9: To be inserted in the application materials by the chairperson. See instructions below.

In preparing your application, please be aware that more applications are received than leaves available and the review process can be competitive. Incomplete applications will not be considered. A written report to the chair, dean and Provost describing accomplishments and benefits of the leave is due within one quarter after return. *Note* Approval of professional leave quarters does not include funding for travel proposed in the application. Funding for travel during the professional leave period is subject to established department and/or college policy related to professional travel, the same as during periods of regular faculty service.

If a leave is awarded, you must agree to return to Western Washington University for a period equal to that of the leave. If you do not return to Western Washington University, you will be required to pay any remuneration received from Western Washington University during the leave. (Chapter 173, Washington Laws 1977, 1st Ex. Session). In compliance with RCW 28B.10.650 (4), remuneration for professional leave shall not exceed the average of the highest quartile of a rank order of salaries for all full time teaching faculty.

Typed Applicant Signature / Click here to enter text. / Date / Click here to enter text.

Office of the Provost 4.19.13

Please answer the following questions. You may either copy and paste text into the boxes or type in directly.

Appendix 1: Detailed statement of plans for utilizing time requested
Click here to enter text.
Appendix 2: Detailed description of how proposed activities contribute to area of study, professional development, and contributions to the university.
Click here to enter text.
Appendix 3: Names of institutions and individuals with which the applicant will be associated, with pertinent itineraries and specific dates.
Click here to enter text.
Appendix 4: A statement of any time to be spent on other duties and any compensation to be received.
Click here to enter text.
Appendix 5: A current vita.
Click here to enter text.
Appendix 6: In cases where technical support is required for the project, a statement of support costs and how these will be met.
Click here to enter text.
Appendix 7: Additional material in support of the proposed program, such as examples of applicant’s work. (Please provide hyperlinks to items such as journal articles, book titles, or music files)
Click here to enter text.
Appendix 8: Copies of reports of previous professional leaves and reports of summer research or teaching grants, or faculty development grants from previous three years. Include descriptions of pending applications for summer research or teaching grants or faculty development grants.
Click here to enter text.
Appendix 9: (To be inserted in the application materials by the chairperson.) Chairperson’s recommendation to the dean, including an evaluation of the merits of proposal and benefits the proposal could provide the faculty member and programs offered in the Department. Chair shall also provide a description of the impact of leave on the department’s course offerings and students’ progress. The chairperson will submit the completed application to the Dean’s office by October 15.
Click here to enter text.

Office of the Provost 4.19.13

Office of the Provost 4.19.13