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Application For Leave - Class Absence Form 1

This document is a student leave application form for Hepshibah Jeyabalan to request a leave of absence from her studies at the university from September 2nd, 2020 to October 7th, 2020. The form requires her to provide her details and reason for leave, and obtain approval signatures from her lecturer(s), the International Office if applicable, and the Head of her Programme. Once completed, the form is to be submitted to the Office of Admissions and Records for processing.

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Hepshibah A/P Jeyabalan
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24 views1 page

Application For Leave - Class Absence Form 1

This document is a student leave application form for Hepshibah Jeyabalan to request a leave of absence from her studies at the university from September 2nd, 2020 to October 7th, 2020. The form requires her to provide her details and reason for leave, and obtain approval signatures from her lecturer(s), the International Office if applicable, and the Head of her Programme. Once completed, the form is to be submitted to the Office of Admissions and Records for processing.

Uploaded by

Hepshibah A/P Jeyabalan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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FORM WI-AAO-03-01

STUDENT LEAVE APPLICATION FORM

(A) To be completed by the student – Please (  ) where applicable

Student’s Name : HEPSHIBAH JEYABALAN Session : B2


Matriculation No : P17008016 Programme : DIB
Email Address : [email protected] Contact No : 0164552434
Application for ‘Leave of Absence’: From 2/09/2020 to 7/10/2020
(Date) (Date)
Reason(s) for requesting leave (Please attach all supporting documents):

Note: Form must be submitted before taking leave or within 72 hours of returning from leave.

8/10/2020
Student’s Signature Date

(B) To be verified by lecturer(s) (Note: Not applicable to IIU & ICN)


Please circle Lecturer’s
Lecturer’s Name Course Code Date Remark(s)
either one signature
MS.HUEY MIIN NG HRM 2100
1. Yes / No
2. Yes / No
3. Yes / No
4. Yes / No
5. Yes / No
6. Yes / No
7. Yes / No

(C) International Office (If you are an International Student)


Comments :
Name: Signature: Date:
(I.O. Personnel)

(D) Head of Programme * (In the absence of Head of Programme, the designated officer will assume the signatory role.)
Approved / Not Approved Comments :

Name: Signature: Date:


(Official Name Chop)
Note: This form is to be submitted to the Office of Admissions and Records (OAR) after approval is given.

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Student – Please keep this acknowledgement slip for reference

Name of student : HEPSHIBAH JEYABALAN Matriculation No :P17008016


Your leave application from 2/09/2020 to 7/10/2020 is / is not approved. Kindly inform
your lecturers. Thank you.

Name: Signature: Date:


(Head of Programme)

STUDENT LEAVE APPLICATION FORM Page 1 of 1 Effective date: 22 Jan 2019


Rev.No:02

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