LEAVE APPLICATION FORM
This form is to be used by both teaching and non-teaching staff of the Institute for availing leave
1. Name of Applicant : _______________________________________________________
2. Designation : ____________________________________________________________
2. Duration of Leave required (in days) : _________________________________________
3. Period of Leave : From___________________________ To__________________________
4. Ground on which leave is applied : ________________________________________________
5. Nature of Leave: CL / EL / EOL / Medical/Paternity/Maternity/ ( Circle/Tick whichever Applicable (if
medical, all the necessary documents need to be attached as per existing rules)
6. Contact address with Phone Number during leave period :
________________________________________________________________________________
Date:-____________________ Signature of Applicant
FOR USE BY PERSONNEL/ADM. OFFICER
1. Leave in Credit__________________ (Entry Page No…….. for CL/EL only)
2. Comments/Recommendations _______________________________________________
Date……………………. Signature of Personnel/Adm Officer
FOR USE BY THE IMMEDIATE SUPERVISOR
I hereby confirm that Mr/Ms__________________________ has made substitution arrangements
with Mr./Ms_________________________ for classes/Workshop Practical during his/her leave of
absence from duty. I recommend leave as applied for subject to his/her leave in credit Remarks /
Comments
Date…………………………….. Signature of Immediate Supervisor
Leave Approved/Not Approved subject to following comment(s)
Date……………………………………. (DIRECTOR)