Report on Completion of Sabbatical Leave

If you prefer, you can use your word processor to compose entries for each item below, then cut and paste text into the appropriate box. Responses are required for entries with asterisks; enter “N/A” for any entry that is not applicable. Note that formatted entries will appear in the report only as plain text.

If you wish to submit supplementary materials via email attachment, click the box in item 6 below. On the review page you will be prompted to attach the file(s).

When you have completed the form click the REVIEW button at the bottom of the page. You will have a chance to review your entries before you submit the form.

First Name *

Middle Name or Initial

Last Name *

Telephone Number *

Email Address *

School or Unit *
Select from menu below; if your unit is not listed, select “Other,” then enter your unit's name in the box below.
College of Arts & Sciences Continuing Studies School of Business School of Education School of Optometry School of Fine Arts SPEA School of Social Work HPER School of Nursing Other

Other School or Unit

Department *

Period of Leave *
Select from menu below; if your period is not listed, select “Other,” then enter your period in the box below.
2009-10 1st Semester 2009-10 2nd Semester 2010-11 Academic Year 2010-11 1st Semester 2010-11 2nd Semester 2011-12 Academic Year 2011-12 1st Semester 2011-12 2nd Semester 2012-13 Academic Year 2012-13 1st Semester 2012-13 2nd Semester 2013-14 Academic Year Other

Other Period of Leave

1. Nature of activity while on sabbatical leave (description of research, creative activity, postdoctoral study or other project) *

2. Progress toward completion of the work for which sabbatical leave was taken (present status of research, development of creative activity, etc.) *

3. Description of travel and residence away from home during sabbatical leave *

4. Plans for publication or other efforts to disseminate the results of your sabbatical leave *

5. Supplementary Comments

6. Supplementary Materials
I want to email supplementary materials