INDIAN INSTITUTE OF TECHNOLOGY : DELHI
 ELECTRICAL ENGINEERING DEPARTMENT
 FACULTY

 Emplyee Code:__________________

APPLICATION  FOR       EARNED,MEDICAL,CASUAL,VACATION LEAVE

 

1. Name of the Employee:___________________________

2. Employee's Code No.:____________________________

3. Designation :  ___________________________________

4. Type of Leave:  _________________________________

5. Period of Leave: From____________ To:______________

6. Reason of Leave: ________________________________

7. Address During Leave:____________________________

      _____________________________________________.

Arrangement s       for        Teaching  Classes         Examinations/
 Investigation    Duties              Whenever           Applicable
______________________________________________________
 

______________________________________________________
 
 
 

Date :                                                    (Signature of Applicant)

Recommended/Not Recommended and Forwarded for  Necessary Action.
 
 

 Head Elect.Engg.Deptt.

Estt-I