Application for Leave
(Academic Staff only)
Name:
Department:
NOTE: Academic staff may be eligible for a period of Leave. However, each request is
considered on its merits and is granted at the University’s discretion.
PURPOSE FOR WHICH LEAVE IS REQUESTED
In this section you should outline in detail the proposed objectives of your Leave, including
publication or other output plans. As a guide, this should be approximately 500 words.
You will need to refer to these objectives in your report at the end of the period of Leave, and to
demonstrate that they have been achieved.
The Head of Department and the Academic Leave Committee will use the information provided
in this section to evaluate your report and any significant change of plans should be notified to
Human Resources in advance.
LEAVE REQUESTED
Please state the terms and the academic year during which Leave is requested, and tick the
relevant box for the type of Leave requested.
PERIOD OF LEAVE
Study Leave
TYPE OF LEAVE
Leave of Absence
(paid, USS
contributions
continue)
(unpaid, USS
contributions cease)
Leave to Accept a
Research Award
(paid, USS
contributions may
continue)
Academic Year:
Term 1
Term 2
Term 3
Please note: There is no automatic right to the sole use of a room by a member of staff if he or
she is on academic leave, though access to a working area should be facilitated where requested.
See http://www2.warwick.ac.uk/services/spacemanagement/spaceallocation/guidelines/ for
more information.
RIGHT TO WORK IN THE UK
Do you currently hold/require a visa to work/remain in the UK?
Yes
No
If yes, please indicate below which type of visa?
GRANT APPLICATIONS
If your period of leave is granted, do you plan on applying for grants whilst you are on leave?
Yes
No
If yes, please provide further details below:
FINANCIAL DETAILS
Give details below of any expected additional income or expenses during the Leave requested. If
you become eligible to receive payments from an outside source after this application has been
approved, you should notify Human Resources as required under Regulation 5(4d).
Where Leave of Absence is requested, the normal expectation is that the University will not be
required to continue payment for its share of contributions to USS. Where the University is
being asked to continue its contributions, this should be made clear below, and a detailed
statement of the financial arrangements to be made during the period of Leave should be
attached. (See Regulation 5).
NOTE: REPORT
In making an application for leave, you agree to provide a Report on the leave to the Academic
Leave Committee, via your Head of Department, within 4 weeks of the end of your leave. This
should be submitted to the Academic Processes team in Human Resources
(academicprocesses@warwick.ac.uk) for consideration by the Academic Leave Committee.
Signature of Applicant ____________________________________________________________
Date _________________________________
STATEMENTS BY HEAD OF DEPARTMENT
(to be completed by Professor Responsible if Head is non-professorial)
Do you recommend approval of this leave application?
Yes
No
Please detail your response below, indicating how the proposed activities contribute towards the
applicant’s academic development.
Please indicate
(i) how the proposed programme of research fits with the Department’s overall research strategy
and whether the objectives and outputs are clearly quantifiable.
(ii) why the objectives set could not be met within the standard workload model.
(iii) whether or not you will be able to make alternative teaching and administration
arrangements during the proposed period of leave. It should be noted that all applications for
leave are approved by the Academic Leave Committee, subject to adequate provision being
made for the covering of the applicant’s teaching and administrative duties.
Signature of Head of Department
___________________________________________________.
Print:
__________________________________________________________________________
Date: _________________________________
Where Professorial Heads of Department are applying for Leave, the form must be countersigned
by another Professor or the Faculty Board Chair.
October 2015