INSIDE DOUGLAS COLLEGE / OCTOBER 3, 1989

 

APPLICATION FORM FOR EDUCATIONAL LEAVE

1. Name College Phone No.

 

Residence Phone No.

ae Discipline or Programme:

 

 

3. Date of regular appointment:

4. Number of years of eligible service (see Article 12.03 and 12.04 of
Collective Agreement)

 

 

5s Period of Leave Requested 4 months LJ 1 year LJ
© 6. Proposed Dates Start:
End:

 

7. Have you been granted educational leave before?

No LJ Yes LJ Dates:

 

8. What remuneration, other than College salary, do you expect to receive
during your leave (e.g. bursaries, grants, scholarships, etc.)

 

 

 

 

Source: Amount: $

Source: Amount: $

Source: Amount: $
Signature Date

 

 

 

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