Annexure- IX

Indian Institute of Management

Application for the Medical Leave/Family Emergency
Name: Mohit Gidwani
Enrolment Number: HAHM22006
Period of Leave: 18/08/2022 (Evening) to 21/08/2022(morning)

Describe the reason for leave (Attach documentary proof viz., Medical certificate etc.)

I’m planning to go to Shri Vaishnav Devi temple as there is the holiday of 3 days. I joined the regular classes from
22/08/2022. So I request you to approve my leave

Whether recommended by the Chairperson (Student Affairs’) and Hostel Warden?

Particular Whether recommended or not? (with signatures)
Hostel Warden
Chairperson (Student Affairs)

Whether approved or not by the Chairperson (MBA)?

Chairperson (MBA)

Note:
For grounds other than sickness or family emergency, leave may not be granted for a period exceeding three
teaching days and even can be denied. Before applying for leave to the Chairperson (MBA), through
Chairperson (Student Affairs’) and Warden, student should contact his/her course instructors to ensure that s/he
is not missing any quizzes or examinations during the leave period. No attendance will be granted for such
leaves. Students must refrain from approaching the visiting and full time faculty members for any exemptions in
attendance on any grounds.
The PGP Office or the concerned faculty will not be responsible for the student losing any segment of
evaluation on account of his/her leave or not meeting the minimum desired attendance of 80%.

In general, for medical treatment in Jammu city or in any other city, student must be referred by the Institute's
Doctor/ Visiting Doctor / Health Centre. Resident Doctor's/Visiting Doctor’s reference may not be required only
in case of emergency.
Page 58 of 64