Leave Application Form for School
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
First Name
Last Name
Student ID
Class & Sec.
Reason for Leave
Bereavement Leave
Emergency Leave
Medical Leave
Other
Leave Duration (Start Date)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Leave Duration (End Date)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
No. of Days
Name & Signature of the Parent/Guardian
For Office Use
Date Received
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Received By:
First Name
Last Name
Position
Leave Status
Granted
Denied
Remarks
Principal's Signature
Submit
Should be Empty: