Sabbatical Leave Report (Fall 2021)
(to be completed upon return from sabbatical leave and returning to full service in Fall 2021; you must complete as described below)  
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Email *
PART I - Signature Page
A hard copy with signatures to be completed upon return from sabbatical leave and submitted to the SLC Administrative Assistant separately.
Download and print the Signature page here.
https://drive.google.com/file/d/1prXfgN2882dp4eX2eMwcfxCloi9zO8zN/view?usp=sharing
Name *
Department *
Date Submitted: *
MM
/
DD
/
YYYY
Academic school year in which leave was taken: *
Semester in which leave was taken. *
(Do not include any unbanking as part of a sabbatical leave)
Required
Check the type of sabbatical leave: *
Required
PART II  -  Restatement of Sabbatical Leave Application.
COPY and PASTE original Sabbatical Leave abstract that was submitted with your application here:
*
PART III - Completion of Objectives, Description of Activities.                            
OBJECTIVE #1:     *
a) Copy and paste objective from application.    
*
b) State the means by which you accomplished objective #1 and provide a description of any materials that you produced/courses completed in the fulfillment of the objective;        
*
c)Indicate the total number of hours dedicated in the accomplishment of objective #1:
OBJECTIVE #2 (if applicable):  
a) Copy and paste objective from application (if applicable)
b) State the means by which you accomplished objective #2 and provide a description of any materials that you produced/courses completed in the fulfillment of the objective;        
c)Indicate the total number of hours dedicated in the accomplishment of objective #2 (if applicable):
OBJECTIVE #3 (if applicable):
a) Copy and paste objective from application (if applicable)
b) State the means by which you accomplished objective #3 and provide a description of any materials that you produced/courses completed in the fulfillment of the objective;        
c)Indicate the total number of hours dedicated in the accomplishment of objective #3 (if applicable):
OBJECTIVE #4 (if applicable):
a) Copy and paste objective from application (if applicable)
b) State the means by which you accomplished objective #4 and provide a description of any materials that you produced/courses completed in the fulfillment of the objective;        
c) Indicate the total number of hours dedicated in the accomplishment of objective #4 (if applicable):
PART IV.   -  Contribution to District
In this section the individual who has concluded his/her sabbatical leave will restate and elaborate upon how the sabbatical activities contribute to the District by addressing the following:

*
a. Explain how the study or project contributed to the professional development of the applicant.
*
b. Explain the anticipated short- and/or long-term benefits of your project on the following groups: students, department, college, and/or community. As appropriate, include specific information on SLOs, PSLOs, Core Competencies and/or equity, diversity, and inclusion.
PART V. Documentation.                                      
If you performed Advanced Academic Studies, your transcripts are to be attached to this section of the hardcopy of your report.If you performed self-directed studies, attach a weekly log in table form (e.g. generated in Excel or Word program – see sample table HERE (https://drive.google.com/file/d/0B65aNZyaBt-lRGowWWtqRkNhVm8/view?usp=sharing) for each objective. A column of hours should be dedicated to each objective with a total of calculated hours at the end of each column. The sum of these columns must total 576 hours or more. You may also add a separate column that indicates any hours devoted to additional activities that were not originally provided in your application. These should not be included in your final sum of approved hours completed.
* Additional Sabbatical Leave Activities may not be counted toward the 576 hours that were originally approved.
Sum total of hours completed for approved activities: *
Link to Google folder with documentation files: *
Please enter the shareable link to your table of hours or, if applicable, to a shareable folder with other documentation such as transcripts, appendices, etc... Make sure the shareable link is set to "view". Press either the enter key or space bar after each link.
THIS IS THE END OF THE SABBATICAL LEAVE REPORT
A copy of your responses will be emailed to the address you provided.
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