Faculty Modified Duties Request Form

Faculty Modified Duties Request Form

Please use the printable document available here.

Process for submitting this request:

1. The Department Head (or Dean, where that is the immediate supervisor) shall complete this form and attach a letter of support for the faculty member taking FMD. If the tenure clock extension policy applies, the Department Head may invoke the automatic extension in the letter of support.
2. The Department Head submits  to the Dean for review.
3. The Dean submits the request and letter of support to the Provost for approval and funding. The Provost’s office will notify the faculty member and department head of the approved FMD and note the faculty member’s revised retention and/or tenure review date.