ZEAL EDUCATION SOCIETY’S
ZEAL COLLEGE OF ENGINEERING AND RESEARCH
NARHE │PUNE -41 │ INDIA
Record No.: ZCOER-ACAD/R/18A Revision: 00 Date:01/04/2021
Student Leave Application Form
Department: Semester: I/II Academic Year – 20 - 20
Class: Div: Date:
To,
Head of Department
Subject: Request for permission to avail the leave
Respected Sir,
I request the permission to avail leave with following details provided that I shall compensate for
average attendance as per desired criteria and the syllabus covered during leave period.
Name of Student:
Roll No.:
Leave details:
Leave Period %
Date of
Reason for Leave No. of Days Attendance
From To Joining
till date
Thanking you,
Yours faithfully,
Sign of Student
(For office use only)
1. Remark of GFM with signature:
2. Remark of Class Teacher with Signature: He/ She is allowed/Not allowed to avail the leave
3. Remark of Academic Coordinator: He/ She is allowed/Not allowed to avail the leave
Head of Department/ FE Coordinator
(This form is to be used by student for all leave application including medical leave. Student has to attach the certificate/concerned proofs
to the concerned GFM after joining the college.)