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  • Baartiya Saucanaa P'Aovaoigaki Samsqaana, (Laahabaad: Indian Institute of Information Technology, Allahabad

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    This document is an application form for students at the Indian Institute of Information Technology, Allahabad to request leave from classes. It requests information such as the applicant's name and contact details, home address, dates of proposed leave, and reason for leave. It notes that applications for personal leave must include a request email from parents supporting the reason and length of leave. Applications for medical leave must include a doctor's medical certificate and prescription. Students are reminded that providing false information on the application could result in disciplinary action.

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    This document is an application form for students at the Indian Institute of Information Technology, Allahabad to request leave from classes. It requests information such as the applicant's name and contact details, home address, dates of proposed leave, and reason for leave. It notes that applications for personal leave must include a request email from parents supporting the reason and length of leave. Applications for medical leave must include a doctor's medical certificate and prescription. Students are reminded that providing false information on the application could result in disciplinary action.

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    © All Rights Reserved
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    15 views1 page

    Baartiya Saucanaa P'Aovaoigaki Samsqaana, (Laahabaad: Indian Institute of Information Technology, Allahabad

    Uploaded by

    shivanshu
    This document is an application form for students at the Indian Institute of Information Technology, Allahabad to request leave from classes. It requests information such as the applicant's name and contact details, home address, dates of proposed leave, and reason for leave. It notes that applications for personal leave must include a request email from parents supporting the reason and length of leave. Applications for medical leave must include a doctor's medical certificate and prescription. Students are reminded that providing false information on the application could result in disciplinary action.

    Copyright:

    © All Rights Reserved
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    of 1

    BaartIya saUcanaa p`aOVaoigakI saMsqaana, [laahabaad

    INDIANINSTITUTEOFINFORMATIONTECHNOLOGY,ALLAHABAD

    (ACentralUniversity)
    (ACentreofExcellenceinITEstablishedbyGovt.ofIndia)
    Deoghat,Jhalwa,Allahabad211012(U.P.),India
    (APPLICATIONFORLEAVEBYTHESTUDENTSIN(20%)PARTOFATTENDANCEINEACHSUBJECT)

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    9.

    NameoftheApplicant&His/herMobileNo.

    His/herEnrollNo.&HostelAddress..

    Name,Address&EmailoftheParent/Guardian.

    HomeTownfullAddress

    FullContactAddressduringleaveperiodincasethevisitisforaplaceotherthanHomeTown...

    Datesofproposedleave

    DetailsofHolidays/Semesterbreaksifanysuffixedorprefixedtotheabove

    Reasonforleaverequested(SpecifiesoneoutofTotallypersonal/AnyInterview/Medical/AnyProgrammingorother
    Competition/PresentingofaConferencePaper/Anyotheretc.)..

    WhetherparentsrequestbyEmailisattachedforproposedperiodofleaveincaseofpersonalleaveElse,ifforanyother
    leave,propersupportdocumentsfromconcernedauthorityareenclosed(Y/N)?..
    ..

    Declaration:I,(NamewithEnrollNo...)herebydeclarethatall
    the information in this application are true. In case any of these is found False/Misleading I shall be liable to due disciplinary
    actionsbytheInstitute.

    Kindly note that no personal leave application will be entertained without accompanying request of the
    Parent/GuardianswhereinHis/herparenthasfullysupportedthereasonforleavealongwiththeperiodofleave.
    II. For Medical leave, the application should accompany the copy of the medical prescription slip & original medical
    certificatebytheconcernedMBBSDoctorfromwhoseadvicethetreatmenthasbeenadministered.

    I.

    (Signature)
    Date:..
    Place:.

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