HILM Islamic School

Application for Leave

1 Name of Applicant

2 Designation

3 HILM ID Number
Nature of leave applied for
4
(CL, EL, ML etc.)

The period for and the date from Total ------- days, (in words) ---------------------
5
which the leave is required.
From -------------------- To-------------------------

The grounds on which the leave is

6
applied for
Class
7 Duties on leave days Subject
Total number of classes

Substituted teacher’s signature: ……………………………………………………………………………….

This year ………….

Type of Leave
Leave enjoyed
Leave yet to be enjoyed
(Including this leave) Total
CL ….

Signature of the applicant: ………………………………………………………………………………………….

Principal/ Coordinator

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