APPLICATION FOR SABBATICAL LEAVE New York Institute of Technology 
Name __________________________________Semester(s) for which applying for sabbatical leave . Fall 20 __ . Spring 20 __Department ______________________________School __________________________________Date began full-time employment at NYIT  ____________________________________Current Rank ____________________ Effective Date ___________________________Tenure (yes or no) _________ Effective Date _____________________________
List all previous leaves of any sort: 	
Type and Purpose of Each Previous Leave                      	Start Date 	End Date 	

Anticipated address during the period of the sabbatical leave: 
Description of Project On this page and the next please provide a concise description of the intended sabbatical activity. Please include the date that the project will begin or began, the present status of the project including any initial work that you have completed, the nature of the proposed project, the names and locations of any authorities or institutions to be consulted during the project, the location(s) at which the project will be conducted, the expected completion date of the project, the expected products of the project (publications, presentations, exhibits, etc.), and the relationship of the project to your long-range professional objectives. 
Description of Project (continued) 
Qualifications and Preparation In the space below, please provide a concise description of your qualifications for this project and your preparation for this project. 
Benefits to NYIT In the space below, please provide a concise description of the benefits to NYIT of your engaging in this project. 
Awards and Grants During Sabbatical Below please list and describe any awards and/or research and travel grants that you intend to apply for, or have applied for, or have received for the period of the proposed sabbatical. 
Financial Support During Sabbatical Below please list any salary or stipends expected during the period of the proposed sabbatical leave, in addition to your salary from NYIT. 
Assurances and Recommendations 
I agree to continue to serve NYIT for at least one year after the expiration of my sabbatical leave, and to submit within one month of my return from sabbatical a written report of my sabbatical activity to my department chair, dean, and the vice president for academic affairs. 
Signature of Applicant  ________________________________ Date __________ 
aApproval indicates that the signatory affirms that the work of the department in which the applicant serves can be so arranged as to be carried forward effectively during the period of the award and that the proposed study, research, or work described in the application is consistent with NYIT’s sabbatical leave principles. 

Please see Current AAUP contract for NYIT Sabbatical Leave Policies 

Application Preparation Information 
**A complete, up-to-date curriculum vitae must be attached. 
**Please attach any additional supporting documentation that you wish. 
**Please ensure that all information in this application is typed.