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SRI

SRIMATHI SUNDARAVALLI MEMORIAL SCHOOL


NAGAPPA NAGAR, CHROMEPET, CHENNAI 600 044

Leave Application
Date :
Applicability Reference School Hand Book

Classes JM1 - XII Page No.99

To School Authorities
Student Name Admn. No. Class & Sec

DD Leave From No. of Days Reason for Leave

MM

YYYY To

DD

MM

YYYY

Kindly grant the above leave for our ward and oblige.

Father
Total Leave Availed till Date Leave Granted Leave Rejected If Rejected Reason :

Mother
(For Office Use Only)

Guardian

Order of Higher Official Agreed Refused If Refused Reason :

Req. No. Req. No.

File. Teacher No. Class File. No.

Date : Date : Signature

Signature

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