NIMS INSTITUTE OF ENGINEERING AND TECHNOLOGY
LEAVE APPLICATION FORM
Name of Student: ……………………………………
Course & Semester: …………………………………………….
Name of the Hostel: ……………………………….… Room No.: ………………………………...................................
Date of Leave: From…………………………………. To ………………………………………………………………
Student’s Contact No. ……………………………….. Parent’s Contact No. ………………………………………
Reason of taking leave:
….................................................................................................….........................................................................................
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Mentor’s/Coordinator’s Statement:
.................................................................................................................................................................................................
Mentor’s/ Coordinator’s Name & Signature: ……………………………………………………..
Administrator’s Approval:
Leave Approved/Not Approved ……………………………………………….....
Administrator’s Name & Signature: …………………………………………………..
Office Seal: ……………………………………….
Documents Required:
1. Copy of student ID Card
