请假表/LEAVE APPLICATION FORM
基本信息 BASIC INFORMATION |
姓名/Name:： 学号/Student ID： 国籍/Nationality： 所在班级/Class： |
请假信息 LEAVE INFORMATION |
请假类型/Leave Type： □事假/Personal Leave□病假/Sick Leave □其他/Other 请假去向/Destination： |
请假起止时间/Leave Period： 至/to （共/Total____天/days____时/hours） |
请假原因 REASON FOR LEAVE |
请假事由/Reason for Leave： |
联系方式 CONTACT INFORMATION |
请假期间联系方式/Contact Information During Leave: |
紧急联系人姓名/Emergency Contact Name： 关系/Relationship： 联系方式/Contact Number： |
审批意见 APPROVAL OPINIONS |
辅导员初审意见 /Counselor's Preliminary Review Opinion： 签字/SIGNATURE： 日期/DATE： |
系（院）审批意见 /Department (College) Approval Opinion： 签字/SIGNATURE： 日期/DATE： |
学生工作部审批意见 /Student Affairs Department Approval Opinion： 签字/SIGNATURE： 日期/DATE： |
分管院级领导审批意见 /College Leader in Charge Approval Opinion： 签字/SIGNATURE： 日期/DATE： |
说明/Instructions：
1.请如实填写各项信息，字迹清晰；请假事由需具体明确，病假须随附正规医疗机构出具的医疗诊断书，其他特殊情况（如涉外事务）须附相关证明材料。
/Please fill in all information truthfully and ensure your handwriting is legible.The reason for leave must be specific and clear.For sick leave,a medical certificate issued by a formal medical institution must be attached.For other special circumstances(such as foreign affairs-related matters),relevant supporting documents must be provided.
2.请假期间需保持本人联系方式畅通，紧急联系人信息需准确有效；离开学校所在地的，需提前告知辅导员详细外出地址。
/During the leave period,you must keep your contact information available,and your emergency contact information must be accurate and valid.If you leave the school premises,you must inform your counselor of your detailed address in advance.
