8/19/2019 Vinal Leave
1/2
Jawaharlal Institute of Technology, BorawanFormat Name: Leave
Application
Format No.:JIT/LA/109Issue: 1.1
JIT0055
Date:18/09/15---------------------------------------------------------------------------------------------------------------------
LEAVE APPLICATI! "#$
To !e "ille# !$ Applicant%Part %A & Lea'e (etails
1. Name:&'ina$ (a)a*an +. Desi,nation: A-
. Department: . Nature o" Leave: 01 L
5. Leave: From:&. 1/0/12 to 1/0/12 2. Leave Duration: 01
#a$s
3. 4u""i/ -re"i 6oli#a$:
&&&Nil&&&&&
8. -urpose o" Leave: ousin !rot)er7s (arria,e
)ign of A**licant
Teac)in, sta"" reuire to su!mit #ul$ "ille# Facult$ alternate
Arran,ement "orm to t)e 6D.
Part % B& !ote +y Lea'e Cler
1. Date ; Time o" receipt o" application :
