The James McKeen Cattell Sabbatical Award
Institution Certification Form
Please mail one copy of this form by December 7 to the address below.
Name of Applicant ________________________________________________________
Academic Rank ___________________________________________________________
Certification Completed by (Name, Title): ______________________________________
1a. Is the applicant a tenured member of
the faculty of your institution?_______________________________________________
b. Will the applicant officially be a tenured member of the faculty by March following this December application?
Will the applicant be eligible for a
sabbatical under your standard procedures in AY 2013-2014?___________________________________
What were the dates of the applicant’s last leave with pay? (Note that for the purposes of this award we consider a leave/sabbatical as any funded leave that allows a faculty member to spend all of their time on research without administrative or teaching responsibilities. Please report here any leave funded by grant support, university/college supported sabbatical or junior faculty leave, but do not report parental or sick leave, or lightened teaching load if administrative/advising responsibilities were still required). ____________________________________________
4. Will the candidate be on sabbatical in the Spring semester of 2013? _______________
What is the applicant's salary for the
present academic year? ____________________________________________________
What payment does your institution make
to a faculty member on sabbatical leave? ______________________________________
Does your institution cover completely the
fringe benefits of a faculty member on sabbatical leave? __________________________
If the answer to the previous question is "No,"
what benefits are not covered, and what is the dollar value of each? _________________