Tutoring and Academic Enhancement Services Tutoring and Academic Enhancement Services

53 Nancayasan, Urdaneta City, Pangasinan 53 Nancayasan, Urdaneta City, Pangasinan

(075) 636-1413 | 0930-435-4909 | 0956-026-6668 plc.urdaneta@gmail.com (075) 636-1413 | 0930-435-4909 | 0956-026-6668 plc.urdaneta@gmail.com

APPLICATION FOR LEAVE APPLICATION FOR LEAVE

Name: __________________________ Date: _________________ Name: __________________________ Date: _________________
Position:________________________ Salary: ________________ Position:________________________ Salary: ________________

DETAILS OF APPLICATION DETAILS OF APPLICATION

B. Type of Leave
Vacation
To seek employment
Others (Specify)
_______________
Sick
Maternity
Others (Specify)
_____________________
No. of working days applied for: ______
Where will leave be spent: A. Type of Leave Where will leave be spent:
In case of Vacation Leave Vacation In case of Vacation Leave
Within the Philippines To seek employment Within the Philippines
Abroad (Specify) Others (Specify) Abroad (Specify)
_________________ _______________ _________________
In case of Sick Leave Sick In case of Sick Leave
In hospital (Specify) Maternity In hospital (Specify)
Out Patient Others (Specify) Out Patient
________________________ _____________________ ________________________
Inclusive Dates:___________ No. of working days applied for: ______ Inclusive Dates:___________

_________________________ _________________________
Signature of Applicant Signature of Applicant
DETAILS OF ACTION ON APPLICATION DETAILS OF ACTION ON APPLICATION
Certification of Leave Credits Recommendation: Certification of Leave Credits Recommendation:
as of ______________ as of ______________
Vacation Sick Approval Vacation Sick Approval
Total Earned Disapproval due to Total Earned Disapproval due to
Less this application Less this application
Balance Balance

________________________ ________________________
Authorized Official Authorized Official
Approved for: Disapproved due to: Approved for: Disapproved due to:
_____ days with pay _________________ _____ days with pay _________________
_____ days without pay _________________ _____ days without pay _________________

ANGELITA T. BARLONGO ANGELITA T. BARLONGO

Owner Owner