PSG POLYTECHNIC COLLEGE
PEELAMEDU - COIMBATORE - 641 004.
APPLICATION FOR LEAVE
1. Name of the Student :
RollNo :
2. Class & Branch :
Sem :
3. Leave required date on / from :
To
4. Reason :
5. Date of online entry by student :
Signature of the Student
Date :
Date of approved by the tutor :
Signature of the Tutor