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NATIONAL INSTITUTE OF TECHNOLOGY DELHI

(An Autonomous Institute under the aegis of Ministry of HRD, Govt of India)
IAMR Campus, Sector A-7, Institutional Area, Delhi 110040, INDIA
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/Tele: +9111-27787500-503, / Fax: +9111-27787503, /Website: www.nitdelhi.ac.in

Leave Form for Post Graduate M. Tech/ Ph.D. Students

Name of the Student :___________________

Roll No. :___________________

Department :___________________

Type of Leave: Casual/Vacation/Medical/Duty (Tic on which is application)

Period Leave: From_________ To_________ No. of days_________(Both day inclusive)

Address during leave period:________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Mobile No:_________________

Student Signature: ________________

Date: ________________
Recommended/Not Recommended
Date: ______________ Supervisors Signature: ____________

Date: ______________ DPGC Convener: _________________

Date: ______________ HOD: ___________________________

Leave Sanctioned/Not Sanctioned