‫طلب االذن بالغياب‬ ‫طلب االذن بالغياب‬

‫االسم العائلــي ‪:‬‬

‫‪........................................................................... ............................................................................................................................. ........‬‬ ‫‪....................................................................................... .............................................................................................................................‬‬ ‫االسم الشخصي ‪:‬‬ ‫االسم العائلــي ‪:‬‬
‫‪........................................................................... ............................................................................................................................. ........‬‬ ‫‪....................................................................................... .............................................................................................................................‬‬ ‫االسم الشخصي ‪:‬‬
‫االطار ‪:‬‬
‫‪...................................................................................................................................‬‬ ‫‪...................................................................................................................................‬‬ ‫رقم التأجير ‪:‬‬ ‫االطار ‪:‬‬
‫‪...................................................................................................................................‬‬ ‫‪...................................................................................................................................‬‬ ‫رقم التأجير ‪:‬‬
‫‪.‬‬ ‫على الساعــة ‪:‬‬ ‫‪/ /‬‬ ‫من يوم ‪:‬‬ ‫‪.‬‬ ‫مدة الغياب ‪:‬‬ ‫‪.‬‬ ‫على الساعــة ‪:‬‬ ‫‪/ /‬‬ ‫من يوم ‪:‬‬ ‫‪.‬‬ ‫مدة الغياب ‪:‬‬
‫على الساعــة ‪:‬‬ ‫الى يوم ‪/ / :‬‬ ‫على الساعــة ‪:‬‬ ‫‪/‬‬ ‫الى يوم ‪/ :‬‬
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‫سبب الغياب ‪:‬‬ ‫سبب الغياب ‪:‬‬
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‫‪.‬‬
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‫‪............................................................................................ ................‬‬ ‫المرفقات ‪:‬‬ ‫‪............................................................................................................‬‬ ‫المرفقات ‪:‬‬

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‫‪..................................................‬‬ ‫بتاريخ ‪:‬‬ ‫‪...................................................‬‬ ‫حررفي ‪:‬‬ ‫‪..................................................‬‬ ‫بتاريخ ‪:‬‬ ‫‪...................................................‬‬ ‫حررفي ‪:‬‬
‫‪.‬‬
‫‪.‬‬

‫التوقيع ‪:‬‬ ‫التوقيع ‪:‬‬

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫راي السيد رئيس المؤسسة ‪:‬‬ ‫راي السيد رئيس المؤسسة ‪:‬‬
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‫‪...................................................‬‬ ‫االمضاء ‪:‬‬ ‫‪...................................................‬‬ ‫التاريخ ‪:‬‬ ‫‪...................................................‬‬ ‫االمضاء ‪:‬‬ ‫‪...................................................‬‬ ‫التاريخ ‪:‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫رأس السيد المدير االقليمي ‪:‬‬ ‫رأس السيد المدير االقليمي ‪:‬‬
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‫االمضاء ‪:‬‬ ‫‪...................................................‬‬ ‫التاريخ ‪:‬‬ ‫االمضاء ‪:‬‬ ‫‪...................................................‬‬ ‫التاريخ ‪:‬‬