1
Jawaharlal Institute of Technology, Borawan
Format Name: Leave Application
Format No.:JIT/LA/109
Issue: 1.1
JIT0169
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LEAVE APPLICATION FORM
(To be filled by Applicant)
Part A: Leave Details
1. Name: Abhishek Yadav 2. Designation: AP
3. Department: Mechanical Engg. 4. Nature of Leave: (CL/DL/EL/LWP) CL
5. Leave: 09/09/2014 to 09/09/2014 6. Leave Duration: 01 Day
7. Suffix/ Prefix Holiday:
8. Purpose of Leave: Personal work.
Sign of Applicant
* Teaching staff require to, submit duly filled Faculty alternate Arrangement form to the HOD.
Part B: Note by Leave Clerk
1. Date & Time of receipt of application:
2. Nature of leave : .. 3. Leave Duration: .. Days
4. Leaves Due : . Days 5. Leaves Balance : .. Days
In case of LWP
5. LWP taken till date : . days.
Sign of Clerk
Part C : Recommendation of HOD/Section Head
1. Total staff on Roll : . 2. Staff already on leave during above period :
3. I have verified that the alternate arrangements made are satisfactory.
4. I will observe that all the lectures of the applicant will be engaged during his/her leave period.
5. The percentage of staff on leave during this period is less then 10 %.
OR
Even if the percentage of staff during this period is more than 10%, I assure you that the department work will not
be hampered due to the leave of applicant.
6. I recommend the leave.
OR
I do not recommend the leave due to (Strike out which is not
applicable)
Sign of HOD / Section Head
Part D : Remarks from the sanctioning Authority
.days CL/DL/EL/LWP . Leave is sanctioned / Not sanctioned.
Director
Part E: In Case of non sanctioning of leave
The leave mentioned in above parts is not sanctioned due to ..
Signature of dealing Assistant.
2
Jawaharlal Institute of Technology, Borawan
Format Name: Leave Application
Format No.: IT/LA/109
Issue: 1.1
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Name of Faculty: Abhishek Yadav Designation: AP
Alternate Teaching Arrangement during Leave:
S.
N
.
Date Day Time of
Lecture
Class Room
No.
Name of Alternate
Faculty
Sign of
Alternate
Faculty
Name and Signature of HOD Name and Signature of Faculty
Alternate Portfolio/Other College Work arrangement during leave
Name and Signature of section In charge Name and Signature of Faculty
S
No.
From
(Date)
To
(Date)
Portfolio/Other
College Work
Name of Alternate Signature of
Alternate
1 09/09/2014 09/09/2014 HOD Ankit Jain