APPLICATION FORM FOR EDUCATIONAL LEAVE

- Name College Phone No.
Residence Phone No.

Discipline or Programme:

Date of regular appointment:

. Number of years of eligible service (see Article 12.03 and 12.04 of

Collective Agreement).
Period of Leave Requested 4 months CJ 1 year J
Proposed Dates Start: End;

Have you been granted educational leave before?

No bed Yes a) Dates:

- 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