ࡱ> HJGe bjbj:: <XgbXgbU$ $ 4h<d4j*)))))))$,.**4$*```)`)``m'(9():*0j*S(r/r/4(r/(`**j*r/$ B f: Form updated by the Office of the Provost: 01/2020 Application for Leave of Absence (to be submitted to department chair by applicant) Sabbatical applications due November 15 Unpaid leave applications due at least 6 months before start of leave Name and Title: __________________________________________________________ Date: __________ Dept: ________________________________________________________ College: __________________ Length of service at UNH, including present academic year: _________________ Type of leave requested: (check as appropriate and state relevant year) Sabbatical: _____ Leave with full pay (1 semester): Fall/year________________ Spring/year________________ Leave with half pay (2 semesters): Fall/year________________ Spring/year________________ Leave without pay: _____ Duration: Fall/year_________________ Spring/year______________ Other__________________ Do you request continuation of benefits: Yes* ________ No ________ (*if yes, applicant must make arrangements with HR) Dean's signature needed for continuation of benefits: ____________________________________ Is any part of the leave contingent upon outside funding? Yes _____ No _____ If so, please explain in detail. (What sort of funding is sought? When would award be announced?) Note: acceptance of an internal UNH award, such as Humanities Center Fellowship or a Faculty Scholar award, relieves the recipient of teaching duties but is not considered a leave of absence. Such awards do not stop either the sabbatical or tenure clock. History of previous leaves at UNH (please include all types of leaves). Note: the sabbatical clock begins at the start of the academic year after the sabbatical. Leaves without pay and FMLA leaves normally stop the sabbatical clock. Date (e.g., fall 2019, fall & spring 2019-20): ______________________________________ ______________________________________ ______________________________________ ______________________________________ Type of leave (e.g., sabbatical at full pay, half pay; FMLA): __________________________________________ __________________________________________ __________________________________________ __________________________________________ Signature of applicant: ______________________________________________ Date: ____________ Signature of dept. chair: ______________________________________________ Date: ____________ Verified: _____ 6 years full-time service _____ Proposal qualifies _____ If applicable, report received after last sabbatical Signature of dean: ______________________________________________ Date: ____________ Signature of provost: ______________________________________________ Date: ____________ I. Attach a copy of full, current curriculum vitae. II. In one sentence, what is the purpose of this leave? III. Use the remainder of this page to describe the project to be undertaken during the leave of absence. This should be a synopsis of the project comparable to a summary that might accompany an application. To be completed by the department chair I. Please indicate the arrangements that will be made to provide the courses and services for which the applicant is normally responsible, specifying in detail any replacement costs that will be required. Note: One semester sabbatical leaves do not free up any money for replacement teaching. In the absence of other funding, replacement staff may not be provided. II. Please give your evaluation of the applicant's program for the proposed leave of absence. You should comment on both the substance of the project and how the leave might contribute to the professional development of the applicant. Comment also on the outcome of the most recent prior leave, if applicable. Signature of dept. chair: ___________________________________________________ Date: _________     Application for Leave of Absence page  PAGE \* MERGEFORMAT 3 +,0234UYijtuyz޺zzjZL<h"%h_p(5CJOJQJ^Jh"%h[6OJQJ^JhsWehsWe6CJOJQJ^Jh"%hsWe6CJOJQJ^Jh"%h_p(6CJOJQJ^Jh"%h[6CJOJQJ^Jh"%hxH[6CJOJQJ^Jh"%h[5CJOJQJ^J#h"%h<5CJOJQJ^JaJ#h"%h_p(5CJOJQJ^JaJhy5CJOJQJ^JaJ#h"%h/5CJOJQJ^JaJ34UT U   d v w , - F G hh^h`h P`gd@` & F$a$$@&a$@&gd/ 0 B I T U X \ ϳϣޓscSCsh"%hCJOJQJ\^Jh"%hxH[CJOJQJ\^Jh"%hxH[5CJOJQJ^Jh"%h(RCJOJQJ\^Jh"%h/CJOJQJ\^Jh"%h/5CJOJQJ^Jh"%h(R5CJOJQJ^Jh"%h/CJOJQJ^Jh"%h[OJQJ^Jh"%h[CJOJQJ^Jh"%h[5CJOJQJ^J"h"%h[56CJOJQJ^J   3 5 c d v w   }}l[M<}} h"%h-?CJOJQJ^JaJh(RCJOJQJ^JaJ h(Rh(RCJOJQJ^JaJ h"%h/CJOJQJ^JaJ h"%h(RCJOJQJ^JaJ h"%h(RCJ OJQJ^JaJ h"%h[CJOJQJ^JaJh"%h[6CJOJQJ^Jh"%h[6CJOJQJ^Jh"%h[CJOJQJ^Jh"%h[5CJOJQJ^Jh"%h_p(5CJOJQJ^J   + , - F G b h k      j v w ޚޫwhwW h"%h[CJOJQJ^JaJh!^6CJOJQJ^JaJ#h"%h[6CJOJQJ^JaJ h"%h(RCJOJQJ^JaJ h"%h-?CJOJQJ^JaJ h"%h(RCJ OJQJ^JaJ h"%h[CJ OJQJ^JaJ h(Rh(RCJOJQJ^JaJ h"%h/CJOJQJ^JaJ h"%h[CJOJQJ^JaJ  w < ;<=>'()X=hFdhgd(RPgd`x`gd(R B S ] _ ;<=>Ͼr`rRD2"h"%h(R5CJOJQJ]^Jh"%h`xOJQJ]^Jh"%h[OJQJ]^J#h"%h(R6CJOJQJ^JaJ&h"%h[6>*CJOJQJ^JaJ&hMh[6>*CJOJQJ^JaJ#h"%h(M6CJOJQJ^JaJ#h"%h[6CJOJQJ^JaJ h"%h[CJOJQJ^JaJh"%h[CJOJQJ^J h"%h[CJOJQJ^JaJ h"%h/CJOJQJ^JaJ>X_'(.356:>?@AGHNUXm~ĴuuuuufffYh"%hZ;OJQJ^Jh"%hZ;CJOJQJ^JhOJQJ^Jh"%h-?OJQJ^Jh"%h[OJQJ^Jh"%h[6OJQJ^JhV6CJOJQJ^Jh"%h[6CJOJQJ^Jh"%hoS6CJOJQJ^JhURCJOJQJ^Jh"%h[CJOJQJ^Jh"%h[5CJOJQJ^J  +,14:=^gESTYZ_`öxhXxxhXXh"%h*5CJOJQJ^Jh"%h_p(5CJOJQJ^Jh5CJOJQJ^Jhk^OJQJ^Jh"%h(MOJQJ^Jh"%h6)4OJQJ^Jh"%hoSOJQJ^Jh"%h[OJQJ^Jh"%h[CJOJQJ^Jh"%h[5CJOJQJ^Jh"%hZ;CJOJQJ^Jh"%h-?CJOJQJ^J"%2379Yhopy|}øzhVVVhV#h.h[5CJOJQJ^JaJ#h.h_p(5CJOJQJ^JaJh.5CJOJQJ^JaJ#h.h*5CJOJQJ^JaJh"%h_p(5CJOJQJ^Jh5CJOJQJ^Jh.OJQJ\^Jh"%h.OJQJ\^Jh"%h.5OJQJ^Jh"%h*5CJOJQJ^Jh"%h[5CJOJQJ^JF%} FGHI !"#$% 0dh^`0gd6)4gd7Qdhgd. dhPgd.dh !"#$:?GHIJLN5tdTdDth"%h/5CJOJQJ^Jh"%h7Q5CJOJQJ^Jh"%h[5CJOJQJ^Jh"%h[OJQJ^Jh"%h[CJOJQJ^Jh"%hoSCJOJQJ^Jh"%h6)4CJOJQJ^J"h"%h6)45CJOJQJ\^J"h"%h7Q5CJOJQJ\^Jh7Qh7QCJOJQJ\^Jh7Qh7Q5CJOJQJ^Jho5CJOJQJ^J%&'()*+,-./01234567_.$dha$$a$dh57NOYZ_c-.2458 ݻ}m`Sm`mDh"%hSfCJOJQJ^JhUR6CJOJQJ^Jh6CJOJQJ^Jh"%h[6CJOJQJ^J%hh[56CJOJQJ\^JhCJOJQJ^Jhh[>*CJOJQJ^Jh"%h[CJOJQJ^Jh"%h[5CJOJQJ^J"h"%h(R5CJOJQJ\^J"h"%h[5CJOJQJ\^Jh"%h|5CJOJQJ^J !"#@&dh  #0167^pᶦ~z~z~z~zrnjb^bShURmHnHu*hmjhmUh_Sh|h|OJQJht(jht(Uh"%h<)5CJOJQJ^Jh"%h_p(5CJOJQJ^Jh"%h[5CJOJQJ^Jh"%hPCJOJQJ^Jh"%hSfCJOJQJ^Jh"%h[OJQJ^Jh"%h[CJOJQJ^Jh"%h[56OJQJ^J@&gdo1$a$$a$ h"%h[OJQJ^Jht(h|ho1CJOJQJhmjhmU*F 00P&P1:p_p(/ =!"#$% Dp= 0&P1:p// =!"#$% P 9 0&P1:p// =!"#$% s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH 8`8 Normal_HmH sH tH DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 4@4 0Header  !4 @4 Footer  !.). Page Number.(!. Line Number4+24  Endnote Text>* A> Endnote ReferenceH*.Q. m0 Header CharHbH `x0 Balloon TextCJOJQJ^JaJN/qN `x0Balloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< )<H<< TTTTTW  >5   F% 6NPW!@ @H 0(  0(  B S  ?+,--02_4:7 8 +,--02Udv-F_X4:_ c 7 8 +,--02ffy;<_56:>@AGHNU4:S T Y Z % 2 3 } } _ _ c c - . 4 5 7 8  # P9y ` 8 {gˠrH"( >t;T0{L2|cECpD!m]sD5B4И 0^`056CJo(.80^8`0o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.hh^h`o(. 0^`056CJo(. 0^`056CJo(.0^`05o(. 0^`056CJo(.80^8`05o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.0^`0o(. 8^8`hH. L^`LhH.  ^ `hH.  ^ `hH. xL^x`LhH. H^H`hH. ^`hH. L^`LhH.80^8`05o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH. ;T08{L {gH"(ECpm]s5B9y c        &P        B¦        R        0//Pe\U#>#(o126)4;7(_!k±U-?mڊdzۤ(<<)|."%Vo1*=[(M@8 8 8 8 @UnknownG.[x Times New Roman5Symbol3. .[x Arial7..{$ CalibriABook Antiqua9. . Segoe UIA$BCambria Math"1h-+G_+G{zG.P1 P1 !d24zz2QHP?Uj2!xx )  Application for Leave of AbsenceFaculty FellowChalifoux, Susan4         Oh+'0 8D d p | $Application for Leave of AbsenceFaculty Fellow Normal.dotmChalifoux, Susan5Microsoft Office Word@m@PmM@:}@JQP1  ՜.+,0  hp  鶹appz !Application for Leave of Absence Title  !"#$%&'()*+,-./012345689:;<=>@ABCDEFIRoot Entry F'K1Table/WordDocument<SummaryInformation(7DocumentSummaryInformation8?CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q