Administrative Offices
Office of Academic Affairs

Indiana University Kokomo

Application for Sabbatical Leave


Background: Indiana University's Policy website provides a general description of the University's Sabbatical Leave Program. It also specifies that the campus deans and chairpersons have a role in determining the eligibility of the faculty for sabbatical leave. At Indiana University Kokomo, this task falls under the Executive Vice Chancellor for Academic Affairs (EVCAA) who is responsible for maintaining faculty service records that are used to determine the eligibility of tenured faculty. The task of applying the policy's guideline on sabbatical leave to individual faculty applications for sabbatical leave has been assigned to the Faculty Development and Grants Committee (FDGC) that reports to the Exectuive Vice Chancellor for Academic Affairs, providing its recommendations on Sabbatical Leaves, Summer Faculty Fellowships, and requests for Grants-in-Aid funding. The FDGC also reviews campus practice with respect to campus-based research funding, including sabbatical leaves. Note, the committee makes reccomendations; the final decision rests with the EVCAA.

Please cut and paste the following form into a Word document and add the text as requested.  Please email your completed form with the Dean's/Chair's signature(s) to Scott Jones ( in the EVCAA's office by October 15th. Signatures may be electronic, or the form may be printed off and scanned.

Name of Applicant:              

Academic Title:                      


Period of Proposed Leave:    

Date of Application:             

Effective date of initial appointment as full-time faculty member at Indiana University at Kokomo:                                    

Period(s) of previous sabbatical leave(s):

Period(s) of leave of absence other than Sabbatical leave:

With Pay:                   Without Pay:            

Approval of department/division chairperson who has forwarded application with statement attached concerning adjustments, additional staff, or other expenditures that will be necessary:



Signature of Vice Chancellor for Academic Affairs certifying eligibility in terms of faculty service:



Chairperson Faculty Development and Grants Committee Recommending Approval



Vice Chancellor for Academic Affairs Recommending Approval




1.   Description of the scholarly activity for which the leave is requested

2. Previous scholarly work related to the proposed project

3.   Place where the work is to be done

4.   Benefits expected

5.   External sources of support

6.   Academic Record:

Academic Experience:

7.   Pledge to the University

I will complete my employment obligation that follows the granting of sabbatical time at Indiana University Kokomo.

_______________________                       _______________________                        _______________

(typed/printed name)                               (signature)                                         (date)