HAZARA UNIVERSITY

MANSEHRA, PAKISTAN
LEAVE APP LIC ATION FORM

Employee’s Name: __________________________________ Department: _____________________________________

Designation: _____________________________________ BPS: _____________________________
Office/Section: ________________________________ Status: ___________________________
LEAVE CATEGORY:
Casual Earned* Maternity Sick/Medical** Duty Leave
Any Other (Please Specify) __________________________________________________
From: ________________________ To: __________________ No. of Day (s) / Hour(s): _____________
Reason: __________________________________________________________________

Applicant’s Signature: ________________________________ Date: _____________________

R E CO MM E ND AT I ON
Leave Record Casual Earned Medical Duty Any Other
Previous Balance
On this Form
Current Balance

Dealing Assistant/ Superintendent: __________________ Date: ________________

Chairperson/HoD’s Name: ______________________________________

Chairperson/HoD’s Signature: ________________________________

Recommended Not Recommended

Dean of the Faculty’s Signature: ______________________________________ Date: ______________

FO R US E O F R E G I S T RA R O FF I C E O N L Y
Received and Reconcile by: __________________________________________ Date: ___/___/____
Submitted in Time Through Proper Channel Required docs attached

Assistant Registrar: ______________________________ Date: _____/_____/____

Deputy Registrar: _______________________________ Date: _____/_____/_____

Registrar: ______________________________________ Date: ____/_____/______

Vice Chancellor: ________________________________ Date: ___/_____/______

* In case of Earned Leave or any other Long Leave, the application must be submitted 15 days prior to the commencement of leave
** In Case of Sick Leave/ Medical Leave, proper/valid medical certificate/ documents must be attached.