Leave Application Form for School
Date
-
Month
-
Day
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
Date
Leave Duration (End Date)
-
Month
-
Day
Year
Date
No. of Days
Name & Signature of the Parent/Guardian
For Office Use
Date Received
-
Month
-
Day
Year
Date
Received By:
First Name
Last Name
Position
Leave Status
Granted
Denied
Remarks
Principal's Signature
Submit
Should be Empty: