INDIAN INSTITUTE OF TECHNOLOGY ROPAR
LEAVE APPLICATION FORM FOR RESEARCH SCHOLARS
(CASUAL/MEDICAL/DUTY/MATERNITY/PATERNITY)
1
Name of PhD Scholar
Entry No.
Purpose of Leave (whether attending
conference/workshop/seminar any
other)
Name of Venue of the
Conference/Workshop/ Seminar
(in case of Duty Leave)
Actual Dates of
Conference/Workshop/ Seminar
From _______________ to ________________
(in case of Duty Leave)
Period of leave & No. of Days
No. of days:_______________
From _______________ to ________________
Prefix/Suffix
Leave(s) availed till date
(except duty leave)
Balance of Leave
(except duty leave)
If station leave required, date of
departure and arrival
Address during leave period with
Mobile Number.
9
10
11
Yes/No
From __________________to ________________
Signature of the Applicant
(with Date)
Research Supervisor(s)
(In case of Casual/Medical/Maternity/Paternity Leave)
Remarks:
Head of the Department/Centre
(In case of Duty Leave or withdrawal for a long period)
Remarks:
Remarks:
Head of Department/Centre
Associate Dean (Research)