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KAPKATENY SECONDARY SCHOOL KAPKATENY SECONDARY SCHOOL

P.O BOX 342, KAPKATENY. P.O BOX 342, KAPKATENY.


TEACHERS’ LEAVE OUT RECORD TEACHERS’ LEAVE OUT RECORD
No. No.
(To be completed in triplicate: Teacher’s Copy, File Copy & HOD’S Copy) (To be completed in triplicate: Teacher’s Copy, File Copy & HOD’S Copy)
FILE REF: _____________________ DATE: ______________________ FILE REF: _____________________ DATE: ______________________
APPLICATION FOR PERMISSION TO LEAVE THE STATION (TEACHERS ONLY) APPLICATION FOR PERMISSION TO LEAVE THE STATION (TEACHERS ONLY)
OFFICER’S NAME: ________________________________ TSC NO. __________ OFFICER’S NAME: ________________________________ TSC NO. __________
DESIGNATION: ____________________________________________________ DESIGNATION: ____________________________________________________
DURATION OF ABSENCE: ________ FROM: __________ TO: ___________ (INCLUSIVE) DURATION OF ABSENCE: ________ FROM: __________ TO: ___________ (INCLUSIVE)
LAST LEAVE GRANTED ON: ______________________________________________________ LAST LEAVE GRANTED ON: ______________________________________________________
TO REPORT ON DUTY ON / AT (DAYS) __________________________________________ TO REPORT ON DUTY ON / AT (DAYS) __________________________________________
REASONS FOR LEAVING THE STATION: _________________________________________ REASONS FOR LEAVING THE STATION: _________________________________________
___________________________________________________________________________________ ___________________________________________________________________________________
___________________________________________________________________________________ ___________________________________________________________________________________
DELEGATION OF WORK DELEGATION OF WORK
DATE CLASS SUBJECT NO. 0F LESSONS TO BE MISSED DELEGATED TO SIGN DATE CLASS SUBJECT NO. 0F LESSONS TO BE MISSED DELEGATED TO SIGN

Permission granted / not granted ________________________________________________ Permission granted / not granted ________________________________________________
Reason: __________________________________________________________________________ Reason: __________________________________________________________________________
Signed: Deputy Principal / Principal ______________________________________________ Signed: Deputy Principal / Principal ______________________________________________
Date: ______________________ Date: ______________________
N/B– Absence for more than 48 hours require application for official leave. N/B– Absence for more than 48 hours require application for official leave.

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