1. University of Virginia
  2. Arts & Sciences

Leave Request

1 Start 2 Complete
Please select all that apply for the time period requested.
Please describe the type of leave you are requesting and why? For example, "I am eligible for Sesqui in S2020 after completing 10 teaching semesters."
If the requested leave does is outside the selection choices, please enter your leave request dates below.
If you are requesting leave beyond your eligible semester, please describe how you will be funded. Examples may be: I would like to take a full year of leave at 1/2 pay. or I am currently seeking funding for the second semester of my year-long request to supplement my Sesqui leave.
Please note if you have an email, you can print to pdf in Outlook, and attach the file.
Files must be less than 2 MB.
Allowed file types: txt pdf .prn.
Files must be less than 2 MB.
Allowed file types: txt pdf.
If you have applied for grants or fellowships that would provide you with a course buyout, please list them here. This helps us plan appropriately for our budgeting requests.
If there is any additional you need to provide, please add it here.