San Mateo
Community College District
Application for Professional
Development Extended Leave (Sabbatical)
Academic Year 2010-2011
Submit an
original plus six copies of this completed application form to the Office of the Vice
President of Instruction on your campus by February 1, 2010 for full-year leaves
beginning in the fall of 2010, or one-semester leaves for either the Fall, 2010 or Spring, 2011 semesters. Upon submission, your application will be
sent on to the Professional Development Committee.
1. Name
of applicant: __________________________________________________________
2. College: Cańada
________________ CSM_______________ Skyline___________
3. Division/Department:
________________________________________________________
4. Date
of hire as a full-time employee of the District:
_________________________________
5. Were
there any breaks of more than one year in your full-time employment by the
District in the last six years? If so,
when were they?________________________________________
6. Have
you taken a sabbatical or one-semester paid leave through Professional
Development as a full-time employee in this District?
If so, specify dates: __________________________
7. Type
of leave requested: Full year
___________ One semester: Fall 2010 / Spring 2011
8. Return
Agreement:
As
specified in the current contract,
should I be awarded an Extended Professional Development Leave of one year, I
agree to render two full years of service to the District following my return
from this leave. If I should be awarded
a leave of one semester, I agree to render one year of service to the District.
If I fail to fulfill this return obligation, the District has a right to
ratably recover salary and benefit costs.
I
further agree to submit to the college President within thirty days following
my return from this completed leave
a report that identifies the manner in which I accomplished
the objectives of this leave and gives evidence of its successful completion,
as specified in the current
contract.
Date:
____________________ Signature:______________________________________
9. Division
Dean’s Comments:
Direct questions to Professional
Development Chair Lyle Gomes (extension 6292).
Extended Leave
(Sabbatical) Application
1. Purpose of leave:
How
will your proposed plan for an
Extended Leave contribute to your
current assignment or to a future assignment in the District? How will this
leave enhance your professional growth? Which services that you now provide or
expect to provide will be improved
by your proposed leave? If you have
chosen a course of independent study, research or a creative project, why have
you chosen to pursue this independently rather than in an institutional
context?
2. Details of plan of study,
employment, independent project or activity:
Please list specific activities that will
be completed to fulfill your proposed plan, including the following, if appropriate:
specific courses and institutions; specific areas of employment and potential
employers; outline of publications; description of independent study or
research; description of creative project. Please provide the anticipated timetable or calendar for carrying out the
activities you will engage in during your leave.
3. Specific
benefits of leave plan:
Describe the specific benefits of
your proposed plan to students in
the District. Describe the benefits to your division, college, and to the
overall needs and goals of the
District. How will you share and/or apply the results of your activities during
your leave with your division, college and the District as a whole?
4. Evidence
of completion:
Please state the means by which you
will report or verify that the proposed
plan for your leave has been completed.
This may include transcripts of courses taken; letters from employers; samples
of creative work; summary of research or other evidence of original work; a
description of plans for application of new skills and knowledge to teaching assignment and/or college program;
a narrative report on the educational
and professional benefits of the activities undertaken.
Individual projects are limited to 30 units of Extended
Leave or any combination of Extended
Leave and Long Term Professional Development Reassigned
time.