San Mateo Community College District
Application for
Sabbatical/Extended Professional Development Leave:
Academic Year
2008-9
Submit seven copies of this completed application form to the Office of the Vice President of Instruction on your campus by February 1, 2008, for full-year leaves beginning in the Fall of 2008, or one-semester leaves for either the Fall 2008 or Spring 2009 semester. Upon submission, your application will be sent on to the Professional Development Committee on your campus.
1. Name of applicant: ___________________________________________________________
2. College: Cañada ________________ 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 2008
/ Spring 2009_
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 Professional Development Leave Committee on my campus 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 (Required):
Direct questions to Professional Development Chairs (Lyle Gomes, CSM, x 6292; Rick Hough, Skyline, x 4193; Barbara McCarthy, Cañada, x 3473) or the AFT office (x 6491).
Sabbatical/Extended Professional Development Leave 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 Mission Statement 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.
TEAR SHEET
(to be returned to the applicant as validation of receipt of application)
Name: ____________________ Campus: _______________ Division: ________________
Date received: _________________ Received by (signature): ___________________________
Application complete: __________________
Application incomplete – the following is missing: ____________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
For Division Dean:
Cost of
substitution/replacement. Base estimated
figure on highest pay rate from hourly salary schedule. A specific dollar figure must be given
for a proposal to be considered.
TOTAL funding requested $____________
Signature
____________________________
Division Dean
For Professional Development Committee:
Proposal is approved ______
Proposal is denied ______
Signature
____________________________
Committee Chairperson
Comments:
For Vice President of Instruction:
Comments:
For President:
Proposal is approved ______
Proposal is denied ______
Comments:
Signature
____________________________
President