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)