Checklist for Applications for 

Fellowship Award 

 

Note: 

• Applications accepted only once per academic year in fall (Deadline * Dec. 1) 
• Code of Practice Regarding Instructional Staff Academic Leaves – Please read for 
complete details on eligibility, types, review and approval, reporting, calendar leave 
dates, terminating leave and compensation. 
• While on leave, the faculty member is expected to devote her/his time and 
energy to the purpose for which the leave was granted. As a general rule, 
employment within or outside of the University during leaves is prohibited, 
unless such involvement is integral to the purpose for which the leave is 
granted, or there is a compelling justification and may be engaged in only 
with prior approval of the president [page 13]. See section III.7. Attestation of 
Applicant on page 3 of the application and section 7. Academic Leaves and 
Multiple Positions on page 13 of the Code of Practice Regarding Instructional 
Staff Academic Leaves (attached to the RFP email). 
• Code of Practice Regarding Instructional Staff Academic Leaves – Please read 
for complete details on eligibility, types, review and approval, reporting, 
calendar leave dates, terminating leave and compensation. 
• Submit form to: provost.eforms@lehman.cuny.edu with a copy to 
Edna.Norman@lehman.cuny.edu and 
Deborah.RhemJackson@lehman.cuny.edu 


 

 

Faculty Name: ____________________________________________________________________________ 

 

School __________________________________Department _____________________________________ 

 

1. Confirmation of Eligibility from HR (Z. Rosa) attached. Yes or No 

 

2. Previous Fellowship or Scholar Incentive Leave? Yes or No 

 

 a) If Yes, copy of last Leave Report attached? Yes or No 

 

 

3. Pay Rate, duration and dates of proposed leave completed? Yes or No 

 

Fellowship Award Information 

Duration and dates of the proposed leave: 

 

 Full year at 80% of biweekly salary rate Semester __________ Semester ________ 

 

 Half year at 80% of biweekly salary rate. Semester__________ 

 

 Half year at full pay Semester__________ 

 


 

 a) If non-consecutive semesters, justification included? Yes or No 

 

 

5. Lehman CV (Updated/Most Recent) attached? Yes or No 

 

6. Detailed description of proposed scholarly activity 

 and/or Research Plan attached? ` Yes or No 

 

Checklist for Applications for 

Fellowship Award - continued 

 

7. Is leave at another Institution? Yes or No 

 

 a) If Yes, Letter of Support attached? Yes or No 

 

 

8. Application Signatures & Approvals: 

 

 a) Faculty Member’s Signature Yes or No 

 b) Chair’s Signature Yes or No 

 c) P&B approval documented. Yes or No 

 d) Dean’s Signature Yes or No 

 

 

Office of Academic Personnel 

 

Date Received: _____________________________________________________________________________ 

 

Reviewed by: _______________________________________________________________________________ 

 

Application Complete? Yes or No 

 

If no, follow-up and result (describe):_____________________________________________________ 

 

 

 

Confirmation of Completed Application – 

 Emailed to Applicant (Date):________________________________________________________