Annexure 1

APPLICATION OF LEAVE OF ABSENCE

School of Business Management

NAME: _______________________________________________________________ Date: ______________

Email ID: _____________________________________________Mobile No. ____________________________
Programme: __________ Trimester _________ Roll No. : ____________ SAP No: ______________________
Leave Period: From: ____________________ to ___________________ No. of Days missed: _______________
Reason: -

I have missed more than 20 % sessions for the reasons as mentioned below and request you to consider this application
for my attendance purposes on a special case basis (As per SRB). I understand that 20 % absence is permitted which
includes sessions missed for all reasons (Personal, Medical etc.)

I also confirm that I have not missed any sessions for any other reasons. (If missed more than below mentioned sessions,
student should specify the reason ________________ and if application with relevant documents have been submitted to
Academic office (YES/NO)

__________________ Enclosures: _______________________________

To be filled by Students
(For Office use)
No. of Class Class attended
Course(s) Exemption Attendance as on
held during during said
To be Filled by Students (s) date:
leave period period

____________________________________ ___________________________
Checked by Course Coordinator (Signature) Verified by AR / DR (signature)

_____________________ ___________________
Approved by: Program Chairperson Dean -SBM

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