leave of absence (g matric)

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  • CENTRE FOR POSTGRADUATE STUDIES

    APPLICATION FOR LEAVE OF ABSENCE (FOR POSTGRADUATE STUDENTS WITH G.. MATRIC NO.)

    SEMESTER .. SESSION .

    INSTRUCTIONS To Candidate 1. Please complete Section A. You are required to submit this form to the Deputy Dean (Postgraduate)

    of your Kulliyyah/Institute. 2. Sponsored students who would like to apply for leave of absence for any reason, must enclose

    consent / approval letter for the leave of absence from their sponsor(s). 3. A student will not be granted a leave of absence unless the following conditions are fulfilled:

    3.1 To attend class as usual and sit for any mid-term/final examinations 3.2 To submit the application form together with a valid air ticket/any travelling documents to the

    Centre before leaving the country. The following table exemplifies some of the reasons and the relevant necessary documents.

    Reasons Supporting Documents

    1. Medical problem e.g.: accidents, and any other serious

    health problems

    Medical report certified by the IIUM Health Centre and, air ticket for International Students

    2. Personal problems e.g.: family problems, marriage problems, stress

    Counselor report certified by the IIUM Counseling & Career Guidance Department or IIUM Health Centre and, air ticket for International Students

    3. Work constraints

    Recommendation letter from employer, air ticket and work permit for International Students

    Please complete the CPS-ADM/1/2005 form if you have any changes in your personal particulars (such as e-mail address & mobile phone number).

    To Deputy Dean (Postgraduate) of the Kulliyyah/Centre/Institute

    1. Please submit the completed form to the Dean, Centre for Postgraduate Studies. 2. Please also ensure the relevant supporting documents are attached.

    Important Notes The implementation of the Leave of Absence has been effective since Semester I, 2001/2002. The counted/uncounted status does not apply to all postgraduate students registered prior to Semester I, 2001/2002.

    NOTE:

    CPS-REG/8/2005 (1) CONFIDENTIAL

    officeTypewritten Text*** 2 SEMESTERS - SEM 1 2013/2014 AND SEM 2 2013/2014

  • - 2 -

    SECTION A : TO BE COMPLETED BY THE CANDIDATE

    1. Name:

    2. Matric Card No.:

    3. Programme:

    4. Telephone No.:

    5. Reason(s) for Leave of Absence requested. Please attach any supporting document(s). .. .....

    **FOR STUDENT ON IIUM FINANCIAL LOAN

    I understand that if my application is successful, my financial loan will be suspended during the approved leave of absence period.

    Students Signature :

    Date :

    SECTION B : TO BE COMPLETED BY THE HEAD OF DEPARTMENT (IF RELEVANT)

    Recommended Not Recommended Remarks: ... .. ______________________ ______________

    Signature & Stamp Date

    SECTION C : TO BE COMPLETED BY THE DEPUTY DEAN (POSTGRADUATE) OF THE KULLIYYAH/ INSTITUTE

    Approved Not Approved Remarks: .. ______________________ ______________

    Signature & Stamp Date

    OFFICE USE (CENTRE FOR POSTGRADUATE STUDIES)

    Date Received Action / Remarks

    officeTypewritten TextTANVIR AHMED

    officeTypewritten TextG1225619

    officeTypewritten TextMIT

    officeTypewritten Text01128050090

    officeTypewritten Text

    officeTypewritten Text

    officeTypewritten Text

    officeTypewritten Text

    officeTypewritten TextMy father, aged 62, has been detected to have LUNG CANCER since last month. Being the only son of my parents, I badly require to accompany him during some travels in overseas hospital. Because my mother alone facing problems to manage this situation. Im facing huge difficulties to continue and concentrate on my postgraduate studies at the moment. I request to issue me a two SEMESTER (SEP 1 13/14, SEP 2 13/14) leave on this urgent family issue.*** Please find attached DOCTORs prescription from Bumrungrad International Hospitaland my TRAVEL TICKET.