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National Society for Earthquake Technology- Nepal (NSET)

Application for Leave



Name: ______________________________Designation: ____________________________

Division: _____________________________Project: _______________________________

I hereby request leave as stated below.

Mark
Box
Type of Leave
Requested
Date
Number of Day(s)
From To

Annual Leave


Sick Leave


Casual Leave


Maternity Leave


Paternity Leave


Leave W/O Pay


Study Leave

Time off in lieu
(Replacement leave)


Other

Reason for Leave:

Impact on ongoing task, any mitigation provision made:


Employee's Signature: _______________________ Date: ________________________
Administration: This part must be filled up by Administration prior to obtaining concurrence from
supervisor
Leave (hours) Leave earned to date (hours) This use (hours) Leave balance (hours)
Annual Leave (AL)
Sick Leave (SL)
Casual Leave (CL)
Replacement for extra
work done

Admin Remarks:


Note: Requested leave must not exceed the balance available for use during the leave year.
Official Action on Leave Application

Supervisor concurrence: _____________________________ Date:___________________________


Instruction/Remarks:_________________________________________________________________
Approved/Disapproved by


Name: ___________________________Signature: ______________________Date:___________________

Remarks:



NSET/Leave-1

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