City of Manila

Universidad De Manila
One Mehan Gardens, Manila City, Philippines 1000
COLLEGE OF CRIMINOLOGY
ON-THE-JOB TRAINING

APPLICATION FOR LEAVE OF ABSENCE

Name of Intern :

Leave Applied for : [ ] OJT [ ] CD [ ] PFT

Agency Assigned :

Date Filed :

Inclusive Date/s of Absence/s :

No. of Inclusive Hour/s of Absence/s :

Reason:
[ ] Sick, specify:
[ ] Others, specify:

Where Leave Spent: [ ] Hospital [ ] Outpatient [ ] Others, specify:

Total No. of Hours of Absences :

Rest assured that I will held myself responsible for any academic requirements missed during my
absence.

Your favorable consideration is highly appreciated. Thank you.

Sincerely, [ ] APPROVED [ ] DISAPPROVED

Remarks:
Name and Signature of Intern

Name and Signature of Parent/Guardian

PROF. JOPHER F. NAZARIO
OJT Coordinator

Date

For the student concerned:

1. Accomplish in duplicate copy. Furnish the OJT Site Supervisor of an approved copy of this form.
2. Submit this form with attached supporting documents.
3. Submit form for processing at least one (1) day before the date of intended absence except in emergency cases.