Pakistan International School Jeddah – English Section

LEAVE APPLICATION
Date: ……………………………….

Student Name:

Class-Section:

Leave Applied From: To:

for _____ days

Reasons for
Leave:

Contact Number

Email Address

Signature

Comment:

* All medical leaves will only be approved with subject to the medical certificate provided.
* No leave is permissible during Tests/Exams except acute medical reason.

(for office use only)

Remarks: ……………………………………………………………………………………………………………………………………
Hiba Rehman (Coordinator SA)

Remarks: ………………………………………………………………………….…………………………………………………………

DHJS/DHMS/DHSS

Remarks: ………………………………………………………………….…..…………Total No. of absences: ………………

Home Room Teacher

 Leave Policy

Acute Medical Family Necessity Transfer of

Reasons or Dependent Sponsorship
Care

Maximum Time 30 days 15 days 30 days

in one session

Recommendation Basic information Letter of Induction or

Required by a licensed about the family authorization for
Documentation health Hospital member or active/impending
(polyclinic not dependent, (with workplace
acceptable) Medical if any)

If the absence If the absence If the leave exceeds 30

exceeds 30 days, exceeds 15 days, days, the student should
the student should the student should discontinue and apply
Other discontinue and re-apply for the for re-admission when
Information apply for approved leave. they are able to return to
As per policy re-admission active study.
when they are In case the leave is
able to return to not approved and
active study. the leave period
extends 30 days,
the student should
discontinue and
apply for
re-admission when
they are able to
return to active
study.

• After 30days of unapproved leave / absence, the admission stands deferred.

All queries must be addressed directly to the student Affairs Office