REQUEST FOR APPROVAL FOR TEACHING AT ANOTHER INSTITUTION

							                   REQUEST FOR APPROVAL FOR TEACHING AT ANOTHER INSTITUTION


 Name:                                                                        Date:
 Department:                                                          Date(s) of Services:
 Meeting Time:
 Describe the nature of these services. Give the name of the course(s), the course number(s), credit hours, and course
 description:




 Approval of this request by the dean of the college will signify that the services described above will not diminish the
 time available for the employee to perform his or her duties at The University of West Alabama and that no conflict of
 interest is involved.
 Request is:                             Approved                                       Denied



If denied, please specify why:




By:
      Dean of College                                                Date
By:
      Department/Division Chairperson                                Date

I have read and understand the statement on outside employment in the Handbook for Faculty and Professional Staff.




Signature of Applicant

Copies to:       Dean
                 Department/Division Head
                 Faculty Member
lty Member