Line-by-Line Instructions for Completing the Form

DATE: Enter the date the form is being completed.

NAME: Enter the faculty member’s full name as it appears in *DEFINE.

UT EID: Enter the faculty member’s UT EID number as it appears in *DEFINE.

TITLE: Enter the faculty members official University title, such as Professor, Associate Professor, Assistant Professor or named professorship or chair (i.e., The Robert B. Smith Chair in Liberal Arts) as it appears on the UT budget.

COLLEGE/SCHOOL: List ALL colleges and schools who contribute salary funds to the faculty member. For example if he/she holds a 50% appointment in Liberal Arts and a 50% appointment in Business, list both colleges. It is not necessary to list colleges where only a zero time appointment is held.

DEPARTMENT: List ALL departments who contribute salary funds to the faculty member. For example if he/she holds a 50% appointment in Economics and a 50% appointment in English, list both departments. It is not necessary to list departments where only a zero time appointment is held.

REQUEST FOR LEAVE WITHOUT PAY (LWOP): Check this box if the faculty member is not receiving any compensation for this time or is receiving financial support that will NOT be administered through a University account. This type of leave should be requested in any of the following circumstances:

Support will be provided through personal funds.
Medical/personal leave taken after all sick leave has been exhausted. In this case, there should be a discussion with the Dean’s Office and Provost’s Office. It should be documented here that such discussion has taken place (give names), and that all sick leave has been exhausted as of (date).
Faculty member will be a visitor at another academic institution who will pay faculty member directly
Faculty member will be paid directly by an agency, foundation, business or institution.

PERCENT TIME: Indicate the percent of the faculty member’s salary which will NOT be paid through a University account.

Tip: Round to the nearest hundredth. For example, 1/3 time should be entered 33.33%; 2/3 as 66.67%, 1/4 as 25%, 1/2 as 50%, 3/4 as 75%, etc.

PERIOD OF REQUEST: Enter specific dates for the duration of the leave. In most cases the leave will exactly be a full semester or academic year using the following dates: Fall: 09/01/XX – 01/15/XX; Spring: 01/16/XX – 05/31/XX; and Long Session: 09/01/XX – 05/31/XX. Complete two forms if a leave is to span two fiscal years.

REQUEST FOR LEAVE FROM THE INSTRUCTIONAL BUDGET (RT): Check this box if the faculty member is receiving support that WILL be administered through a University account. This type of leave should be requested in any of the following circumstances:

A Faculty Research Assignment (FRA) has been awarded through the Faculty Development Program. With this type of leave request, it must be forwarded to the Dean’s Office along with the Faculty Research Assignment Acceptance Form sent to the faculty by the Office of the Vice Provost and Dean of Graduate Studies. Upon approval by the dean, the original form will be returned to the Office of the Vice Provost and Dean of Graduate Studies.
An external grant or contract has been received which will pay all or part of the faculty member’s long session salary, and will be administered through University accounts.
A faculty member’s salary will be paid by a non-teaching University account.

1.a. ACTIVITIES WHILE ON LEAVE INCLUDING PROJECT TITLE/DESCRIPTION WHERE APPROPRIATE (REASON FOR REQUEST.)
State the reason for the request. If this is a research leave, define the title or description of the research. If it is a personal leave or medical leave, so state. If the leave involves being paid by another institution, agency, business or foundation, indicate the nature of the work to be performed (teaching, research, analysis, etc.). Be as specific as possible.

1.b. WHERE WILL INDIVIDUAL BE WORKING?
Indicate the city, state, country, where faculty member will be working. If there is another institution, agency, business or foundation involved, list the name.

2.a. SOURCE(S) OF LEAVE STIPEND (INCLUDE PERCENT TIME FUNDED BY EACH SOURCE)
List all sources of funds contributing to the faculty member’s salary, account number (if a UT account), and the exact percent time from each source. Do not abbreviate the names of agencies or schools. Make certain all percent times add up to 100% exactly. Some examples are:

Example #1 (LWOP 33.33%, RT 33.33%):
- 33.33% National Science Foundation grant, 26-1111-5555
- 33.33% Rockefeller Foundation grant (paid directly to faculty member)
- 33.34% Remain on Economics Faculty Salaries
Example #2 (RT- FRA 50%/50%):
- 50% Faculty Development Program, 14-14xx-2001
- 50% Remain on Faculty Salaries, 14-1624-2001
Example #3 (100% LWOP):
- 100% University of California at Berkeley

2.b. HAS FUNDING BEEN APPROVED?
If an external grant or other funding has been requested but not approved, do not submit the leave request until funding has been secured UNLESS the leave deadline has arrived. In this case, answer this question "NO", but indicate when you expect a decision will be communicated to you. If funding has been secured, enter "YES." When personal funds are involved, "N/A" is appropriate.

3. WHY IS LEAVE IN THE BEST INTERESTS OF THE UNIVERSITY? (HOW WILL THE LEAVE IMPROVE THE INDIVIDUAL’S TEACHING AND SCHOLARSHIP?)
Answer this question directly. Indicate what is hoped will be added to the faculty member’s experience, what might be brought to the classroom, what publications would result, etc.

4.a. LENGTH OF SERVICE AT UT AUSTIN:
Indicate the number of academic years of service here at UT Austin. Also, enter the beginning date of first employment. For example: 27 years (began September 1, 1973).

4.b. DATES OF PREVIOUS LEAVE:
List all leaves taken as a faculty member. This would include LWOPs, RT as well as FRA’s. These may be viewed by staff on the AL1 screen in *DEFINE.

5. WHAT ARRANGEMENTS ARE BEING MADE TO STAFF CLASSES THAT THE INDIVIDUAL IS/WAS SCHEDULED TO TEACH DURING THE PERIOD OF LEAVE?
Typically, the departmental chair will complete this section. If leave was requested early enough, it could be that no classes were scheduled. If so, it is fine to say that. However, if classes were scheduled, then you must document how those classes are being covered. List course number, unique number, and who will be teaching the class. If the course was cancelled, so state, but also include an explanation of how the students are being accommodated. Also, outline what teaching activities will remain with the faculty member if they are requesting less than 100% leave.

SIGNATURES:

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.
DATE the signature.
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.
DATE the signature.

SUBMISSION:
Submit fully completed and signed Faculty Request of Leave form to:

Lonnie Lisenbee COLA Dean’s Office GEB 3.310 G6000

Contact

Please direct comments on the Procedures Guide to cola_comments@utlists.utexas.edu.

Last Modified: 2 May 2012