Short-Term or
Medium-Term Research Leave

1	Applicant:____________________________

School:  ____________________________   Position: ________________________

Dates of proposed leave: ______________   to __________________________

Request is for medium-term (more than 2 to 6 weeks in length) or short-term research leave (up to 2 weeks)?

2	Research program:

Aims,			methods,			justification:

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3             Relationship of leave objective to School/Centre’s Strategic Operational Plan:

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4             Applicant’s signature: ___________________________   Date: _________

5             Approvals (indicate with signature):

Signature of Executive Dean: _________________________ Date: __________

Comments (note if teaching and administrative duties are covered):

6	Approved by Dean RPGS

Signature: __________________________ Date: __________

Comments: __________________________________________________________
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