Sabbatical Leave Report Form
For UNAC and UAFT faculty
Your report is due no later than three (3) months after the conclusion of your sabbatical leave.i
Name:
Rank:
Sabbatical Leave Dates:
College/School:
Department:
Additional material may be attached in response to the following summary:
1.
List the objectives of your sabbatical leave as stated in your application and indicate how completely they
were met.
2.
Provide a summary of your sabbatical activities and the associated benefits to yourself and UAF.
3.
Funding source/s:
(Please record all funding received while on sabbatical, including grants, honorariums, and compensation from
other institutions.)
UAF sabbatical salary
Other (specify):
Other (specify):
$
$
$
Number of months:
Number of months:
Number of months:
Other (specify):
$
Number of months:
Faculty Signature
Date
Department Head Signature
Date
Director Signature (if applicable)
Date
Dean Signature
Date
Provost Signature
Date
i
See the UNAC CBA at Article 16.6.e and/or the UAF Blue Book Regulations at Chapter VI.A.8.
UAF Office of the Provost, March 2016