Application For Leave: Mabalacat National High School

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FORM 6

APPLICATION FOR LEAVE


2. NAME

1. OFFICE / AGENCY/ DISTRICT

MABALACAT NATIONAL HIGH SCHOOL


(Last)

3. DATE OF FILING

(First Name)

4. POSITION

DETAILS OF APPLICATION
6. TYPE OF LEAVE

7. WHERE LEAVE WILL BE SPENT

Vacation

1. IN CASE OF VACATION LEAVE

To seek employment

Within the Philippines

Others (Specify)

Abroad (Specify)

Sick

w/ pay

w/out pay

Maternity

w/ full pay

w/ half pay

2. IN CASE OF SICK LEAVE


In Hospital (Specify)

Others (Specify)

Out - Patient (Specify)

Number of Working Days applied:


Requested

Inclusive Dates:

Signature

____________________________________

Employee No. _______________

DETAILS OF ACTION OF APPLICATION


8. CERTIFICATION OF LEAVE CREDITS
as of _________________________.

9. RECOMMENDATION:
Approved

Vacation

Sick

Total
Disapproved due to

Days

Days

Days

KHRISTINE MARIE SANTOS


Personel Officer I
10. APPROVED FOR:
Days with pay

JENNIFER Q. CUNANAN
Principal IV
11. DISAPPROVED DUE TO:

Days without pay


Others
MA. IRELYN P. TAMAYO, Ph. D.
Officer-in-charge
Office of the Schools Division Superintendent

VE

(Middle Name)

5.MONTHLY SALARY

BE SPENT

CATION LEAVE

e Philippines

al (Specify)

ent (Specify)

Not Requested

Signature
No. _______________

ON

ved due to

IFER Q. CUNANAN
Principal IV

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