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Form 6 Blank

This document is an application form for leave from the Department of Education Division of Bukidnon. It requests information such as the applicant's name, position, monthly salary, type of leave being requested, number of days, and dates. It includes sections for certification of leave credits by the registrar and approval or disapproval by the school principal. The instructions at the bottom specify that applications for vacation or sick leave over one day must be filed using this form and that medical certification is needed for sick leave over five days.

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enrique nemenzo
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573 views

Form 6 Blank

This document is an application form for leave from the Department of Education Division of Bukidnon. It requests information such as the applicant's name, position, monthly salary, type of leave being requested, number of days, and dates. It includes sections for certification of leave credits by the registrar and approval or disapproval by the school principal. The instructions at the bottom specify that applications for vacation or sick leave over one day must be filed using this form and that medical certification is needed for sick leave over five days.

Uploaded by

enrique nemenzo
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Department of Education

Region X- Northern Mindanao


DIVISION OF BUKIDNON
Sumpong. Malaybalay City
www.depedbukidnon.net.ph

APPLICATION FOR LEAVE


CSC Form 6
(Revised 2015)
1. Office/Agency Employee ID/Number:
DepEd- Division of Bukidnon School/Office: Impasugong National High Schoo
District: Impasugong I
Employee Contact Number:

2. Name:
(Last Name) (First Name) (Middle Name)

3. Date of Filing: 4. Position:


5. Monthly Salary:

6.a. Type of Leave 6.b. Where leave will be spent in case of Vacation Leave?
Vacation Leave
To seek employment
Forced Leave
Sick Leave In case of Sick Leave, please specify the place of recovery.
Maternity Leave
Others (Please Specify)

Commutation: Requested
7. Number of working days applied: Not Requested
Inclusive dates:

(Signature over Printed Name of Employee)

JENNIFER M. DULLA
School Principal

DETAILS OF ACTION ON APPLICATION

7.A. Certification of Leave Credits 7.B. Recommendation


Vacation Leave Credits Sick Leave Credits Total Leave Credits Vacation Leave Credits Sick Leave Credits

MARITES R. DANIOT
Registrar

7.C. APPROVED FOR: 7.D. DISAPPROVED due to:


days with pay
days without pay

JENNIFER M. DULLA
School Principal

1. Application for Vacation or Sick Leave for one full day or more shall be made on this form and to be accomplished in four copies.
2. Application for Vacation Leave shall be filed in advance. In case of sick leave exceeding five days shall be accompanied with medical certificate.
3. An employee who is absent without approved leave shall not be entitled to receive his salary corresponding the period his authorized leave of absence.
National High School
pasugong I

quested

oyee)

Total Leave Credits

D due to:
tificate.
ave of absence.

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