BANARAS HINDU UNIVERSITY
Faculty of Education, Kamachha
Date: / /
To,
The Head & Dean
Faculty of Education, BHU, Kamachha
Through: Proper Channel
Subject: Application for Leave
Part-A
1. Name: ………………………………………………………………Designation: …………………………………………...........
2. Enrolment No & Registration Year: ………………………………………………
3. Department/Faculty/Institute: …………………………………………………….
4. Nature of Leave: …………………………………………………………………………..
5. Date of Leave: From To Total Period-...............
6. Station Leave (If availing): From AM/PM To AM/PM
7. Purpose of Leave: ……………………………………………………………………………..............................................
..............................................................................................................................................................
8. Address during the period of Leave: ………………………………………………………………………………………………
9. Signature of Research Scholar: …………………………….........................................................................
Part-B
Personal Leave Details: Date. .........................to Date.............................=.........Days
Date. .........................to Date.............................=.........Days
Date.... .......................to Date.............................=.........Days
Total Days:. ............Days
1. Number of days leave availed: ………………………… (Days) Remaining Leave :………………(days)
2. Applying Leave for: .............Days
3. Whether leave applied for is recommended: Yes/No
4. Forwarding Note/Recommendation of the Supervisor:.......................................................................
(Signature of the Supervisor with date):..................................................................................................
Part-C (For Office Use Only)
Order of the Sanctioning Authority:
1. Leave as requested at SI. 4 only from……….....................To ……………….................is sanctioned.
2. Leave applied for is not granted.
Signature with date
(Head & Dean)