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    Leave & Local Guardian Form

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    INFO STATIONERS
    This document contains forms for students to request leave from their hostel, nominate a local guardian, and provide an undertaking. The leave form requires information such as the student's name, semester, hostel, dates of leave, purpose, and location. It must be signed by the student's parent. The undertaking states that if the student does not meet the minimum attendance, they will not be allowed to take their exams. The local guardian form requires details about the nominated guardian such as their name, relationship to the student, address, and signature. It must be signed by the student's parent.

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    Leave & Local Guardian Form

    Uploaded by

    INFO STATIONERS
    80 views2 pages
    This document contains forms for students to request leave from their hostel, nominate a local guardian, and provide an undertaking. The leave form requires information such as the student's name, semester, hostel, dates of leave, purpose, and location. It must be signed by the student's parent. The undertaking states that if the student does not meet the minimum attendance, they will not be allowed to take their exams. The local guardian form requires details about the nominated guardian such as their name, relationship to the student, address, and signature. It must be signed by the student's parent.

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    This document contains forms for students to request leave from their hostel, nominate a local guardian, and provide an undertaking. The leave form requires information such as the student's name, semester, hostel, dates of leave, purpose, and location. It must be signed by the student's parent. The undertaking states that if the student does not meet the minimum attendance, they will not be allowed to take their exams. The local guardian form requires details about the nominated guardian such as their name, relationship to the student, address, and signature. It must be signed by the student's parent.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    80 views2 pages

    Leave & Local Guardian Form

    Uploaded by

    INFO STATIONERS
    This document contains forms for students to request leave from their hostel, nominate a local guardian, and provide an undertaking. The leave form requires information such as the student's name, semester, hostel, dates of leave, purpose, and location. It must be signed by the student's parent. The undertaking states that if the student does not meet the minimum attendance, they will not be allowed to take their exams. The local guardian form requires details about the nominated guardian such as their name, relationship to the student, address, and signature. It must be signed by the student's parent.

    Copyright:

    © All Rights Reserved
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    of 2

    LEAVE FORM

    REQUISITION BY THE PARENTS FOR THEIR WARD TO PROCEED ON LEAVE/TO LOCAL GUARDIAN

    1. Name of student : Ms/Mast....................................................................................................


    2. Semester/Year : ..................................................................................................................
    3. AIR/Roll No. : ....................................................................Room No.:………………………….
    4. Name of Hostel : Girls/Boys Hostel IHM Ahmedabad, Gandhinagar.
    5. Period of leave : From................................(am/pm) To.............................(am/pm).
    6. Purpose : ................................................................................................................
    7. Place : ................................................................................................................

    I hereby authorise my son/daughter to proceed on leave on the abovementioned dates


    unescorted at my own risk, responsibility and expense.

    Signature, full name and address of father/mother

    Signature : .............................................................

    Date : Full Name : ............................................................

    Place : Relation : Father/Mother

    I hereby verify that this requisition has Address : ................................................................

    been signed by my Father/Mother. .................................................................................

    Full Signature of student.......................... .................................................................................

    Name of student...................................... Tele/Mobile No.......................................................

    UNDERTAKING

    I, Ms/Mast.............................................. 1st /2nd /3rd year student of B Sc. at IHM Ahmedabad,


    residing at the hostel do hereby undertake that I am leaving the hostel for leave at my own risk. If, I
    fail to secure minimum required attendance criteria. I will not be allowed to write the term end
    semester exams.

    Signature of student.................................

    Date : Full Name.................................................

    Place : Year : .......................................................

    AIR/Roll No...............................................
    REQUISITION BY THE PARENTS FOR NOMINATION OF LOCAL GUARDIAN

    I, Mr/Mrs..........................................................Father/Mother of Ms/Mast.............................................

    1st /2nd /3rd year student of IHM Ahmedabad, who is residing at Room No............................. at
    Boys/Girls hostel, IHM Ahmedabad. I, do hereby nominate the following person, whose particulars
    are given below, as Local guardian to my ward :-

    Full Name of the person : Mr/Mrs ....................................................


    Please paste a
    Relation with the student : ............................................................... passport size colour
    photographs of the
    Full residential address : .................................................................. person nominated
    as Local Guardian
    ...........................................................................................................

    ..........................................................................................................

    ..........................................................................................................

    Tele/Mobile No(s).............................................................................

    Three specimen signature of the person nominated as Local Guardian.

    ........................... ............................. .................................

    Signature of Father/Mother...........................................

    Full Name of Father/Mother..........................................

    Full residential address : ................................................

    .......................................................................................

    ......................................................................................

    ......................................................................................

    Tele/Mobile No (s).......................................................

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