REQUEST FOR APPROVAL TO ENGAGE IN OUTSIDE ACTIVITIES

NAME (Please Print):           ____________________________________________________

NAME & ADDRESS OF ORGANIZATION:  _______________________________________

DESCRIPTION OF OUTSIDE ACTIVITY:  
(Be as complete and specific as possible; attach sheet, if additional space is required).

__________________________________________________________________________

__________________________________________________________________________

1. Would this outside activity involve compensation over and above out-of-pocket expenses?  YES   NO

2. CLASSROOM SUBSTITUTION:             Circle one:

1. No classes would require substitute instruction.
2. Substitute instruction would be required in the following classes (list course number, hour, and location along with substitute instructor’s last name):
   
   _______________________________________________________________
   The alternative arrangement for covering these classes have been approved by the Department Chairperson in a memorandum on file in the department.

3. TIME PERIOD AND AMOUNT OF TIME REQUIRED FOR OUTSIDE ACTIVITY:

This activity would begin ____________ and end ____________ and involve: _______  (hours or days)

My engagement in this outside activity will not interfere with the regular and punctual discharge of my official University duties and responsibilities. 

____________________________________________________ Signature of faculty member requesting approval	_______________ Date
RECOMMENDED    /   NOT RECOMMENDED
____________________________________________________ Dean, College of Law	_______________ Date

Revised 5/20/94