INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

Application for leave from Postgraduate students

(Ph.D. / M.Tech . / M . Des . / .D.I.I.T)

To,
The Head of the Department of
Indian Institute of Technology
Bombay

1. Name of the student:
2. a) Department
b) Elective
c) Roll No.
d) Date of joining
e) Hostel No.

3. Dates on which leave required: From   to

4. Reasons for Leave
Supporting documents (if any):

I understand that leave cannot be availed of unless sanctioned by the competent authority .




_____________________
   Signature of student

5. Recommendations of the Guide/
Faculty Adviser



_____________________
   Signature of student

(This portion is to be filled in by the Departmental office )

6 . He / She is eligible for 15 30 45 days leave in a year out of which he / she has availed of

days of


7. Checked by:



Orders of the Sanctioning Authority
  1. Leave granted with Scholarship ( )
  2. Leave granted withour Scholarship ( )
  3. Leave not Granted ( )



Head of the Department

Note : For grant of special leave beyond the permissible limit, the application is to be referred to the Dean of Academic Programmes.