Line 1. Positions.
Include all primary and joint positions, even if from multiple colleges. Note: Position ID’s can be provided by a department administrator.
Line 2. Leave Type.
Choose up to two types per form, if applicable. Additional forms may be submitted if necessary.
Line 2a. Leave Reason.
Check all boxes that apply.
Line 2b. Project Title or Subject.
Provide the name or subject matter of project you will be involved with while on leave (if applicable).
Line 2c. Description of Activity.
Provide a brief description of activities to be conducted during leave period. e.g. Conduct research related to work on book.
Line 2d. Source of Leave Stipend.
Include percent time funded by each source for both LWOP and RT requests. Include account number(s), if known, for Release Time requests. If an external organization/institution is paying the faculty member directly then that organization's name should be noted. Personal Funds should be noted in cases where a faculty member’s own funds are being used.
LWOP (100%): Guggenheim Foundation 75%, personal funds 25%
RT (50%): National Science Foundation 25% (26-XXXX-XXXX), National Institutes of Health 25% (26-XXXX-XXXX)
Line 2e. Work Location.
Include international and/or domestic location(s); do not use abbreviations.
Line 3. Benefit to the University.
Include a brief description of why the leave is in the best interest of the university and how it will improve your teaching and scholarship. e.g. Will bring prestige to the university and new ideas and concepts to the classroom.
Line 4a. Length of Service.
Provide the number of years of faculty service at UT Austin.
Line 4b. Previous Leave(s).
Include the dates for all LWOP and RT leaves taken within the past five years.
Line 5a. Teaching Arrangements.
List the class(es) that will not be taught and describe how each will be handled. e.g. Class(es) will be canceled, taught in another semester, or taught by another faculty member (provide name).
Line 5b. Instructional and Service-Related Activities.
Describe the instructional and service-related activities that the faculty member will still be responsible for during the leave period. e.g. Supervision of graduate students, individual instruction courses, course development, advising, serving on budget councils and departmental committees. Indicate "None" if not applicable.
Line 6a. Salary Supplement.
Individuals on leave without pay for personal reasons may not continue to receive their supplement during the period of leave. The dean's office should provide instructions for handling the supplement, if applicable.
REQUESTOR: The faculty member requesting leave must sign this form. If he/she is unavailable, attach a copy of an e-mail or letter wherein he/she indicates that he/she is requesting the leave as it is outlined on the form.
DEPARTMENT CHAIR: Signature by departmental chair. Chairs of all departments where the faculty member holds a paid appointment must sign the same form if the leave will be distributed among current appointments. There is enough room to add lines manually. Contact the other department(s) involved to coordinate the processing of the form.
Submit fully completed and signed Faculty Request of Leave form to:
Please direct comments on the Procedures Guide to firstname.lastname@example.org.
Last Modified: 17 August 2014