APPLICATION FOR CHILD CARE LEAVE
1. Name of the Applicant:
2. Designation:
3. Dept/Office/Section:
4. Name of Child for whom Child Care leave is applied for:
5. Date of Birth of the Child:
6. Date on which child will be attaining 18 years:
7. Is the child among the two eldest Children:
Yes
No
8. EL in credit (as on date):
9. Period of Leave (From):
Period of Leave (To):
Prefix/Suffix of holidays, if any:
10. Reason(s) for leave applied for:
11. Total Child Care Leave availed till date:
12. (a) Whether permission to leave station is required:
Yes
No
(b) If Yes, Address during leave period:
13. Date of return from last leave, & nature and period of that leave:
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