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Request for New Parent Appointment Extension for Non-Tenure-Line Academic Council and Medical Center Line Faculty
(See Sections 2.1.D(2)b and 2.5.C of the Faculty Handbook for the full text
of the New Parent Extension policies http://facultyhandbook.stanford.edu)
Instructions to Faculty Member: please fill out this form and submit it to your Department Chair for approval (or in the case of Schools without departments, to your School Dean’s Office)
Instructions to Department: please submit the completed New Parent Extension form along with a Recommendation for Amendment of Professorial Appointment form (Appendix C) to request an extension to the appointment
Name: __________________________________________________________________
Title: ___________________________________________________________________
Department/School: _______________________________________________________
Date of birth or arrival of child: ______________
Signature: ____________________________________________
Date of Request: ______________
To Be Completed by Dean’s Office:
Date Received : ____________________________________
End date of current appointment: ____________________________________
Extension Date (NTL &MCL only): __________________________________
Previous final date of time toward tenure by length of service (TL only):
________________________________
New final date of time toward tenure by length of service (TL only):
________________________________
Approved: ___________________________________________
Date: __________________________
Cc: Faculty member
Department chair
Dean’s Office