RAMCO INSTITUTE OF TECHNOLOGY
BOYS/GIRLS HOSTEL
LEAVE APPLICATION
Name of the Student
Year & Branch
Reg. No.: Hostel Room No.:
Day(s) From: To:
No. of days of Leave required
Out Time: In Time:
Reason for Leave
Phone/Contact No.:
Address during Leave
Date of Leave Application
Signature of the Student
Concurrence received through
Phone from the Parents Yes/No (Date & Time) Signature of Mentor
Recommended/ Not Recommended Permitted/ Not Permitted
Class Adviser HOD Deputy Warden / Warden
(This portion to be retained by the Caretaker in the file and should produce to the higher Officer on demand)
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RAMCO INSTITUTE OF TECHNOLOGY
BOYS/GIRLS HOSTEL
LEAVE APPLICATION
Name of the Student
Year & Branch
Reg. No.: Hostel Room No.:
Day(s) From: To:
No. of days of Leave required
Out Time: In Time:
Reason for Leave
Address during Leave Phone/Contact No.:
Date of Leave Application
Signature of the Student
Concurrence received through
Phone from the Parents Yes/No (Date & Time) Signature of Mentor
Recommended/ Not Recommended Permitted/ Not Permitted
Class Adviser HOD Deputy Warden / Warden
(This portion to be retained by the Caretaker in the file and should produce to the higher Officer on demand)
---------------------------------------------------------Tear here ------------------------------------------------------
Date & Time out at Main Gate: Date & Time in at Main Gate:
Signature of the Security Guard / SO
Form No. HT 04a Rev. No. 03 Effective Date: 19.09.2018
