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Forms for UW Faculty

Tenure/FTRC Clock Stop Request Form

Please don't fill out this input box.

Faculty Member's First Name*

Faculty Member's Last Name*

Academic Rank*

If Other, please specify:

UW Email Address*

Unit Name*i.e. Department, School, Program

Unit Head's Name*Dept Head, Director, Chair

Unit Head's UW Email Address*

Subdivision Name*

i.e. College or college-like unit

Dean/Director*

Reason for Clock Stop*

Childbirth/Adoption

Extenuating Circumstances

If extenuating circumstances, additional documentation may be requested.

Rationale for Clock Stop*Please give a brief explanation for the request to stop the clock.

Have you discussed this with your Department Head?*

Yes

Have you discussed this with your Dean/Director?*

Yes