TEMPLE UNIVERSITY
REQUEST FOR LEAVE OF ABSENCE WITHOUT PAY
PURPOSE:
The primary functions of a faculty member are as a teacher, researcher, and contributor to the academic
purposes of the department, college, and university. Leaves without pay shall not be permitted to interrupt
these major responsibilities in undue fashion.
Normally, such leaves shall be available for one year or less to meet the personal and professional needs of
the faculty member. All such leaves require the approval of the department chairperson, the Dean, and the
Provost.
For good and sufficient reason, the leave may be extended for one more consecutive year. Good and
sufficient reasons shall include research or other professional activities that contribute to the development
of the faculty member and are in accord with the academic purposes of the college, and personal
emergencies. These must be stated in writing. Final decision is by the President of the University.
REQUIREMENTS:
When leave without pay is granted, the faculty member is expected to pay his/her and the University’s share
of the cost of benefits if there is a wish to maintain them.
Ordinarily, no leave during the year of tenure review will be authorized. In no case will leaves of absence
accrue toward the time for tenure eligibility. Further, a one-semester leave of absence will remove the
entire year from consideration for tenure.
The above conditions have been read and accepted.
___________________________________________
Signature of Faculty Member
___________________________
Date
TEMPLE UNIVERSITY
REQUEST FOR LEAVE OF ABSENCE WITHOUT PAY - INSTRUCTIONS
TO FACULTY MEMBERS:
Attached is a statement of the Leave of Absence policies. A more detailed statement, approved by
the Council of Deans on July 19, 1978 and by Cabinet on July 24, 1978 is available in your Dean’s
Office.
Action on your request will be based on the information you submit on the forms provided. Please
sign the statement, complete the data form, and forward to your Department Chairperson.
TO DEPARTMENT CHAIRPERSON:
Sign copy of request and forward to Dean.
TO DEAN:
1. Please append your signature and recommendation.
2. Submit to the Office of the Vice Provost for Faculty Affairs who will forward the application to
the Provost for approval.
3. A copy will be returned to the requesting faculty member with a cover letter from the Provost
or the President approving the Leave of Absence.
4. A copy will be returned to you for your personnel files.
LEAVE OF ABSENCE REQUEST
Name:
Rank:
TUID:
Address:
School:
Department:
Date Appointed: MM/DD/YY
Tenured
Non-Tenured
Period for which leave is requested: (Indicate exact dates)
Academic Year:
Semester(s):
From: MM/DD/YY
To: MM/DD/YY
Purpose for which leave is requested. Provide name of organization or university to be attended.
Post-doctoral study:
Graduate Study:
Research or Creative Work:
Personal:
External Employment:
Visiting Professor at another Institution:
Other:
Summary of proposed program (attach detailed statement): ENTER TEXT HERE
Previous leaves with or without pay (give dates):
Expected date of return:
______________________________________________________
Signature of Applicant
Department Chair Approval: Leave Recommended
__________________________________________________
Signature of Department Chair
Dean Approval: Leave Recommended
Yes
Yes
No
__________________________________
Date
No
__________________________________________________
Signature of Dean
Provost Approval: Leave Approved
Yes
___________________________________
Date
__________________________________
Date
No
__________________________________________________
Signature of Provost
__________________________________
Date