INDIAN INSTITUTE OF TECHNOLOGY : DELHI
 ELECTRICAL ENGINEERING DEPARTMENT

 Application for long/medium leave to take up
 advanced research/teaching assignment
 and/or any other academic purpose in
 India or abroad
 ____________________________________

 

1. Name       :

2. Designation &      :
 Department/Centre

3. Date of joining the Institute  :

4. Field of specialization   :

5.(a) Purpose of leave
   (i) Faculty/Research Position/ :
                 Training or any other
   (ii) Regular/Temporary   :

  (b) Designation    :
  (c) Name & Address of the
             organisation (during leave)

  (d) Financial Arrangements

Amount to be received as  :
  salary fellowship/stipend/
  per diem/honorarium,travel
  grant of any other
  consideration
  Who will provide the
  financial supports ?

 NOTE : Enclose photocopy of
   the offer giving details
   of 5(a) through (d).

6. Importance of assignment for self
 development and Institute programmes.

7. Details of leave availed
 previously for such assignments.

8. Period of leave requested
 (i) Date of commencement leave
 (ii) Date of return to Institute.

NOTE :  Faculty members will not leave or
    return in the middle of a semester.

9. Nature of leave requested.

10. Present commitments and arrangements
 during leave period for

(i)  Teaching

(ii)  M.Tech./Ph.D thesis
  supervision
(iii) Sponsored Projects
(iv)  Consultancy Projects
(v)  Any other Institute
                 responsibility

11. If residing on campus,
                 indicate whether

(i)  Your family will continue:
             to stay in the residence;
(ii)  You will make the house
         available for temporary
         allotment to a faculty
         member/research staff of
         Institute as caretaker
        during leave period.  If
        yes, enclose Form No.
       duly filled.
 

Date: Signatures of the faculty member

12. Remarks/recommendations of
         the Head of the Department
        Centre
 * (i) No.of faculty members

 * (ii) No. of slots available
            under prescribed limit
            of faculty being out of
            the Department/Centre
            at any given time.

 *   (iii) No.of slots already
            committed and details
            thereof e.g. names of
            faculty period of leave/
            visit.etc.

  (iv) Will the assignment be in
        the academic/research
        interests of the Deptt./
       Centre and/or the faculty
       member concerned ?

  (v) Comment on the proposed
        arrangement under serial
       No.10, after consulting
       student(s), faculty member(s)
       and sponsoring agencies.

  (vi) Recommendations of the
        Professorial Committee

 * To be completed, when the period
     exceed three months.
 

Dated :                                                      Signature of Head of Deptt./Centre
 

13. Remarks by Establishment
      Section-I

 (i) Particulars of assignment
      and duration

 (ii) Period of leave requested  From   To

 (iii) Eligibility:
  (1) Leave of the kind due

  (2) Sabbatical Leave

  (3) Extra-ordinary leave

 (iv) Slot position
 

 (v) Leave entitlement

  (a) Date of joining  IIT Delhi

  (b) Length of service on                         Year    Months   Days
   the Date of commence-
   ment of the Leave

  (c) Leave entitlement on the
   basis of 1/5th of service

  (d) Leave availed in the past

  (e) Balance of Leave :

 (vi) Recommendations of the Deptt.

    (vii) General remarks
 

Superintendent (E.I)                                                       Asstt.Registrar (E.I)

14. Recommendations of the
 Deputy Director (F)

15. Decision of the Director

 (a) Approved
 (b) Orders (if any)