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Borang Cuti Tanpa Rekod

Borang Cuti Tanpa Rekod

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Published by: azmir_sadri on Feb 07, 2012
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06/13/2014

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LAMPIRAN 11

( PINDAAN 87 )
PERMOHONAN CUTI
No. Fail Perseorangan:__________________________
1. Nama:_________________________________________________________________
2. Jawaan:________________________________________________________________
!. "ela#a$an A$a%emi$:________________ &. "ela#a$an I$'isas:_______________
(. )a*i +ersi' ,e$arang:________________ -. .ari$' M/la Dilani$:_____________
7. .ari$' 0/i Di1o'on:________________________________ iai/ selama:________ 'ari
8. 0/i23/i #ang ela' %iam4il a'/n ini ( N#aa$an ari$' %an *enis 3/i #ang ela' %iam4il )
________________________________________________________________________
________________________________________________________________________
5. ,e4a42se4a4 memo'on 3/i:__________________________________________________
_________________________________________________________________________
16. Ji$a 3/i /n/$ mengam4il 1e1eri$saan7 sila n#aa$an:
( *a%/al wa$/ 1e1eri$saan 'en%a$la' %isera$an )
(a) Jenis Pe1eri$saan ( Pe1eri$saan Pen/' 8 ,a/ Maa Pela*aran )
____________________________________________________________________
(4) Maa Pela*aran %iam4il:_________________________________________________
____________________________________________________________________
(3) No. "e4enaran 9n/$ Mengam4il Pe1eri$saan ini:___________________________
.ari$':________________________ ____________________________
.an%aangan Pemo'on
0aaan: +orang ini 'en%a$la' %i$em/$a$an %alam ! salinan.
Ia i%a$ 4ole' %ig/na$an /n/$ memo'on 3/i re'a.
+orang ini 'en%a$la' %i$em/$a$an selewan#a %/a mingg/ se4el/m 4er3/i ($e3/ali 'al m/sa'a$
%an segera ) %an sesalinan +orang "el/l/san ole' )/r/ +esar 'en%a$la' %isam1ai$an $e Ja4aan
Pen%i%i$an Pera$ ( /.1: 9ni Per$'i%maan .a%4iran ) /n/$ re$o%.
__________________________________________________________________________________
PERAKUAN GURU BESAR
__________________________________________________________________________________
__________________________________________________________________________________
.ari$':_________________ ____________________________
.an%aangan )/r/ +esar %an 0o1
KEPUTUSAN KETUA JABATAN
0/i %i4enar$an 8 i%sa$ %i4enar$an %engan 4erga*i 1en/' 8 se1ar/' ga*i 8 an1a ga*i 1a%a masa
1e1eri$saan sa'a*a.
2. ,ila $em/$a$an La1oran Per/4a'an se4an#a$ - salinan.
.ari$':_____________________________ ____________________________
.an%aangan "e/a Ja4aan %an 0o1

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