Jawaharlal Institute of Technology, Borawan

Format Name: Leave Application

Format No.:JIT/LA/109
Issue: 1.1
Date: 27-06-2014

JIT 0210

--------------------------------------------------------------------------------------------------------------------LEAVE APPLICATION FORM

(To be filled by Applicant)
Part A : Leave Details
1. Name : JAYPAL RATHOUR

2. Designation : Asst. professor (Trainee)

3. Department : CIVIL ENGG

4. Nature of Leave : (CL//EL/LWP)CL

5. Leave : From .. 28/06/2014 to 28/06/2014

6. Leave Duration : 01day

7. Suffix/ Prefix Holiday :

8. Purpose of Leave PERSIONAL
Sign of Applicant
* Teachin g staff require to submit duly filled Faculty alternate Arrangement form to the HOD.
Part B: Note by Leave Clerk
1. Date & Time of receipt of application :
2. Nature of leave : ..

3. Leave Duration : .. Days

4. Leaves Due : . Days

5. Leaves Balance : .. Days

In case of LWP
5. LWP taken till date : . days.
Sign of Clerk
Part C : Recommendation of HOD/Section Head
1. Total staff on Roll : 8+2+1.
2. Staff already on leave during above period : 01
3. I have verified that the alternate arrangements made are satisfactory.
4. I will observe that all the lectures of the applicant will be engaged during his/her leave period.
5. The percentage of staff on leave during this period is less then 10 %.
OR
Even if the percentage of staff during this period is more than 10%, I assure you that the department work will not
be hampered due to the leave of applicant.
6.

I recommend the leave.

OR
I do not recommend the leave due to (Strike out which is not
applicable)
Sign of HOD / Section Head

Part D : Remarks from the sanctioning Authority

.days CL/DL/EL/LWP . Leave is sanctioned / Not sanctioned.
Director
Part E: In Case of non sanctioning of leave
The leave mentioned in above parts is not sanctioned due to ..
Signature of dealing Assistant.

Jawaharlal Institute of Technology, Borawan

Format Name: Leave Application
Format No.:JIT/LA/109
Issue: 1.1
Date 27/06/2014

--------------------------------------------------------------------------------------------------------------------Name of Faculty: JAYPAL RATHOUR

Designation: Assi. professor (Trainee)

Leave: From: .. .. 28/06/2014 to 28/06/2014

Alternate Teaching Arrangement During Leave:
S.No

Date

Day

Time of Class Room

Lecture
No.
NO LECTURE

Name of Alternate
Faculty

Name and Signature of HOD

Sign of Alternate
Faculty

Name and Signature of Faculty

Alternate Portfolio/Other Collage Work arrangement during leave:

S
No.

From
(Date)

To
(Date)

28/06/14

28/06/14 TG

28/06/14

28/06/14

Name and Signature of section In charge

Portfoli
o/Other
Collage
Work

TRAINING

Name of Alternate

Signature of Alternate

Ms shobna
choudary
Ms shobna
choudary
Name and Signature of Faculty