Form No: 315

Indian Institute of Technology, Kanpur

Research & Development

Application for Casual Leave

Date:16/12/19

To,
The Project Investigator,
Nptel ,
Media Technology Center,
IIT Kanpur.

1. Name : Amita Singh

2. Designation: Sr. project Associate (WA)
3. Personal File No: Work Assignment
4. Leave applied for:_3_days from:_17/12/19 To:_20/12/19 till
half day
5. Purpose/comments: End semester Examination
6. Leave Address, if going out of Station:

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Signature of applicant:
Date:_____________________

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Leave Sanctioned/ Not Sanctioned

Head of Dept/Section