NATIONAL LAW UNIVERSITY AND JUDICIAL ACADEMY, ASSAM
LEAVE GRANT FORMAT
‘Name of the Student
uID Semester, Year,
Cont, No, & E-mail Id
Type of Leave : [ Academic Leave
(puta tick on the From: To:
appropriate option) C) Medical Leave
C Other, specify
Reason for Leave Application
Total number of Leave applied for (excluding holiday, if any):
1 ificate
2. tion / Permission for Participation Letter
3. Certificate of Participation in Moot Court Competition / Seminar / Workshop Conference ete.
4. Others
Signature of Student
Forwarded by Concerned Authority ***
FOR OFFICE USE
Record a8 OM. ......soyeeeeeeeenene(Date):
‘Academic Leave "Medical Leave - Others
‘Leave Availed [Leave Balance | Leave Availed | Leave Balance |Leave Availed [Leave Balance
Leave Granted [] / NotGranted []
Leave Granted from to
For a period of day(s).
Dy. Registrar (Academic) &
Examination (/C)
* A student shell be eligible for attendance benefit on Medical grounds if helshe has fulfilled the minimum attendance
requirement of 65% in individual courses and an aggregate of 70% aliendance in the entre semester
** The approved Academic Leave benefit up to a maximum of 12 working days may be given to those students who already
have te requed percentage of aendane (75) nthe concerned Pape. )
**4 Chief Co-ordinator (Academics) Pacully Adviser // Medical Officer of NLUJA, Assam.