LEAVE APPLICATION FORM
Employee’s Name: _____________________________________ Employee Code:
Designation: __________________________________________ Date of Joining: _________________
Department / Office: School / Institute:
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Leave Type: FULL HALF SHORT
From: __ To: _____________ No. of Days (s) / Hours (s): _ _______ _
Leave Category:
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Casual /Sick* Earned Maternity Any Other _____________________
Reason:
Applicant’s Signature: ___________________ Date:
Officiating Officer’s Name:
Officiating Officer’s Signature: ________________________ Date:___________________
RECOMMENDATION
CoD / Immediate In-Charge: ________________________________ Date: __________________
Dean / Director/ Head of Support Office: _____________________ Date: __________________
FOR OFFICE USE ONLY
Received By: _________________________ Date: ___________________
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Leave Record
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Casual / Sick |
Earned |
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Previous Balance |
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On This Form |
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Current Balance |
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Head OHR: _________________________ Date: _____________________
Rector: __________________________ Date: _____________________
Remarks: ___________________________________________________________________________
*In Case of Sick Leave for more than three days, a valid medical certificate must be attached.
