GRAPHIC ERA UNIVERSITY

LEAVE APPLICATION FORM (TEACHING STAFF)

1. NAME:-

2. DESIGNATION:-

3. DEPARTMENT :-

4. TYPE OF LEAVE(TICK APPROPIATE BOX/BOXES)

(a) Casual leave (b) Duty Leave

(c) Vacation Leave (d) Station Leave

(e)

5. PROCEEDING OUT OF STATION YES NO

6. PERIOD OF LEAVE: - FROM……………………..TO……………………………….

7. PURPOSE OF LEAVE:-…………………………………………………………………….

8. ARRANGEMENT FOR TEACHING LOAD/OTHER DUTIES: ………………………………………………………………..

……………………………………………………………………………………………………………………………………………………..

9. ADDRESS, IF GOING OUT OF DEHRADUN: ……………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………..

PHONE NO: MOBILE:

SIGNATURE

_______________________________________________________________________________________________

1. LEAVE AVAILED ALREADY DAYS

2. LEAVE DUE(STILL) DAYS

3. LEAVE ASKED FOR DAYS

4. BALANCE,IF ANY DAYS APPROVED

ENTERED IN LEAVE REGISTER

ASSISTANT H.O.D

NOTE: Faculty Members who are assigned examination duty will route their application through the Controller of
Examinations.