Application for Long Leave: Research Leave Overseas Exceeding 23 Calendar Days
1.Name:2.Designation:
3.Employment status (Full or Part Time):
(If part time state portion of full time equivalent)
4. Academic Unit[1]:
5. Date leave commences:6.Date leave ends:
7. Itinerary (account for each day from day of departure to day of return to NZ):
8.Total calendar days away:
Comprising:
Number and dates of Long Leave days (include weekend days contiguous to Long Leave days and travel days; this is the number of days to be debited against days accumulated for Long Leave):
Number and dates of annual leave days (minimum 20/365 of total days away rounded up to the next whole day if Long Leave exceeds 90 days; excludeweekend days contiguous to annual leave days):
Number and dates of weekend days contiguous to annual leave days(other weekend days to be included in Long Leave days above):
Number and dates of NZ statutory and/or MasseyUniversity holidays:
9.Purpose *:
10.Research outputs and/or other benefits that will be achieved if leave granted :
11.Research outputs entered in Massey Academic Outputs Database (MAOD) since last Long Leave or, if no previous Long Leave, in last 3 years (please cut and paste from MAOD and update if necessary; do not attach PBRF evidence portfolio or a CV):
12.Date employment with MasseyUniversity commenced:
13.Long Leave and Research Leave in New Zealand over past 6 years (dates and research outputs and/or other benefits achieved –* copies of reports submitted for all periods of Long Leave and Research Leave in New Zealand in previous 6 years to be supplied if requested by LAAC):
14.If total time away from MasseyUniversity will exceed 318 calendar days, state Short Leave taken in last 6 years (dates, purpose of each Short Leave plus total number of days Short Leave in last 6 years):
15.Costs directly attributable to the leave (excluding any conjoined annual leave, New Zealand statutory and Massey University holidays which must be funded personally but including New Zealand statutory holidays and Massey University holidays on which an applicant is required to work) and daily allowance for which funding is sought:
(i)Travel*
(ii)Transport to and from airports, seaports, bus or train stations
(iii)Massey University Travel insurance * (Long Leave days only)
(iv)Domestic and international departure taxes *
(v)Conference fee
(vi)Daily allowance (Long Leave days only)
(vii)Other (specify)
_____
TOTAL: _____
NB: Do not claim for accommodation and/or meals in addition to the daily allowance
16.Funding
Funding available from LAAC:
(i)Funds accrued pursuant to Long Leave Regulation 9 Financial Assistance for Long Leave (maximum $8,000.00 per leave):
Funding available from University General Ledger (GL) accounts pursuant to Long Leave Regulation 9 (vii) Academic Unit/College Funding for Long Leave:
(i)Academic Unit: (identify)
(ii)College: (identify)
Total of available GL funding (maximum $4,000.00)
Funding available from University Project Ledger (PR) accounts pursuant to Long Leave Regulation 9 (vii) Academic Unit/College Funding for Long Leave:
(i)Academic Unit: (state account numbers)
(ii)College: (state account numbers)
Total PR funding available
Total funding available from all MasseyUniversity sources (maximum $20,000.00):
Non–MasseyUniversity Funding:
(i)Personal:
(ii)Other: (identify)
17.Applicant’s certification
I certify that:
(i)Long Leave Regulation 1 Application permits me to make this application; and
(ii)I have complied with conditions (iv) (disclosure of non-Massey University financial assistance) and (viii) (compliance with Massey University Travel Policy and Massey University International Travel Procedures) stipulated in Long Leave Regulation 7 Conditions; and
(iii)my total time overseas will not exceed 318 calendar days (including annual leave, statutory and Massey University holidays) or I seek approval under Long Leave Regulation 5(ii) Exception to 318 Calendar Day Maximum; and
(iv)the total financial assistance from all sources that I will receive, excluding my Massey University salary, will not exceed my total reasonable actual expenditure directly attributable to the Long Leave (excluding conjoined annual leave, New Zealand statutory holidays and Massey University holidays); and
(v)I will comply with condition (v) (Submission of Leave Report) stipulated in Long Leave Regulation 7 Conditions.
Applicant’s signature:Date:
* Attach
1.Evidence of prior arrangements to visit persons/institutions if purpose includes such visits.
2.Orbit Corporate Travel confirmation of fares, insurance costs and departure taxes.
3.Printout from YourSelf Portal confirming approval of annual leave required to be taken with Long Leave.
18.Head of Academic Unit[2] certification
I certify that the following conditions stipulated in Long Leave Regulation 7 Conditions are satisfied:
(i)Contributions to MAOD
(ii)Teaching and other duties covered
(iii)Annual Leave requirement if Long Leave exceeds 90 days
(vii)Maximum duration of 318 calendar days unless approval is sought under Long Leave Regulation 5 (ii) Exception to 318 Calendar Day Maximum.
I confirm the availability of funds from General Ledger and Project Ledger accounts as detailed in Clause 16 of this application but certify that I will not release any of these funds unless LAAC approves their use pursuant to Long Leave Regulation 9 (vii) Academic Unit/College Funding for Long Leave.
I do/do not support this application because:
Head of Academic Unit signature:Date:
Submission to LAAC
Following certification by the Head of Academic Unit, the original of this application plus 7 backed copies must be forwarded to the Secretary, LAAC.
[1]Unit means department or equivalent.
[2]Head of Unit means Head of Department or equivalent.