Scribd
Upload
79 views1 page

Department of Electronics Engineering: Request For Outstation Leave

This document is a request for outstation leave from the Department of Electronics Engineering at the Indian Institute of Technology in Dhanbad, India. It contains fields for the applicant to provide their hostel, room number, name, admission number, semester, branch, purpose of leave, dates and times of departure and return, total days absent, and contact telephone number. Signatures are required from the applicant, head of department/course coordinator, warden, and the Dean or Associate Dean of Academics to approve or reject the request.

Uploaded by

joydeep12
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
79 views1 page

Department of Electronics Engineering: Request For Outstation Leave

This document is a request for outstation leave from the Department of Electronics Engineering at the Indian Institute of Technology in Dhanbad, India. It contains fields for the applicant to provide their hostel, room number, name, admission number, semester, branch, purpose of leave, dates and times of departure and return, total days absent, and contact telephone number. Signatures are required from the applicant, head of department/course coordinator, warden, and the Dean or Associate Dean of Academics to approve or reject the request.

Uploaded by

joydeep12
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

DEPARTMENT OF ELECTRONICS ENGINEERING

INDIAN INSTITUTE OF TECHNOLOGY (INDIAN SCHOOL OF MINES) DHANBAD


JHARKHAND, INDIA, PIN- 826004

REQUEST FOR OUTSTATION LEAVE

No: Dated:

Hostel: ______________________________________________ Room Number: __________________________

Name of Applicant: ___________________________________________________________________________

Admission No: _________________________ Semester ___________________ Branch_____________________

Purpose: ____________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Date and time of leaving station: _________________________________________________________________

Date and time of expected return: ________________________________________________________________

Total days of absent: ___________________________________________________________________________

Contact Telephone Number: _____________________________________________________________________

Signature of Applicant with date

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

Signature of Head of the Department/ Course Coordinator:

Signature of Warden

Approved/ Rejected

Dean (Acad)/ Associate Dean (Acad)

You might also like