UTSC Research and Study Leave Deferral Request Form 2017-18

This request form should only be used for regular paid research and study leaves. Please talk to your Chair/Director if you are thinking about any other type of leave.

Name: Click here to enter Name.

Rank: Click here to enter text.

Department: Click here to enter Department.

Department of Budgetary Cross Appointment (if applicable):

Click here to enter Budgetary Cross Appointment.

(In the case of budgetary cross appointments, request forms should be sent to the head of the home department, and an additional copy - marked as such - provided to the other academic unit head for information purposes).

Requested By:

Date Eligible for Leave:

Full Leave Deferral (requires 6 years of service):

Half Leave Deferral (requires 3 years of service):

Only complete this form if you are planning to take a half leave next year

If Half Leave Deferral is requested by the Faculty Member, please state the reason(s):

Click here to enter reason(s) for deferral.