APPLICATION FOR PERMISSION (FOR REGULAR HIGHER STUDIES)
(Academic Year 2025-26)
Tick the Appropriate Program : M.Tech. Ph.D.
1. Name: …………………………………………………………………………………………………………………………………………………………………
Recent
2. Post: …………………………………………………………………………………………………………………………………………………………………
Self Signed
3. Branch: ………………………………………………………………………………………………………………………………………………………………… Photo
4. Institute: ……………………………………………………………………………………………………………………………………………………………
5. Mention PSC Year and Merit Serial Number: …………………………………………………………………………………………………………………………………
6. Serial Number in latest Gradation List: …………………………………………………………………………………………………………………………………………………
7. Date of First Joining : ………………………………………………………………………………………………………………………………………………………………………………………………
8. Basic Pay and Pay Scale: ………………………………………………………………………………………………………………………………………………………………………………………
9. Is Ph.D./M.Tech necessary for your next Promotion as per Service Rules (Yes/ No): ……………………………
10. Is Ph.D./ M.Tech necessary for your next CAS as per Service Rules (Yes/ No): ……………………………………………
11. Have you ever availed permission in any scheme for M.Tech./ Ph.D. (if yes give complete
details) ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………
12. Date and order details of Completion of Probation: ………………………………………………………………………………………………………………
13. How many teachers are posted in your department: ……………………………………………………………………………………………………………
14. List of such Institutes where you would like to peruse your studies (Maximum 3)
(i) ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
(ii) ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
(iii) ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Declaration by Candidate
I have read and understood study leave rules of State Government for permission to do my
M.Tech./Ph.D. and I accept them. I hereby declare that all the information given above is true and
correct to my best knowledge and belief. In case anything is found false or incorrect at later stage,
necessary disciplinary action may be taken against me.
Signatures …………………………………………………………………………………
Post ………………………………………………………………………………………………
Branch …………………………………………………………………………………………
Address ………………………………………………………………………………………
Mobile Number …………………………………………………………………
Email ID ………………………………………………………………………………………
Recommendation of Head of the Institution
I have personally examined the above application made by …………………………………………………………………………………………
For the permission of higher study under State Government's study leave rules.
It is hereby certifiy that Shri/Smt./Ku. ………………………………………………………………………………………………………………………………………………
is eligible for this leave.
All entries made by him/her in this form are correct as per my office records, knowledge and
belief. Based on this, his/her name is recommended/ not recommended for issuing the Permission.
Note: State Reason clearly if not recommended for permission: ………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Dispatch No: ………………………………………………………………………………………
Place/ Date: …………………………………………………………………………………………
Office Seal: …………………………………………………………………………………………… Signatures …………………………………………………………………………………
Post …………………………………………………………………………………………………
Address ………………………………………………………………………………………
Mobile Number …………………………………………………………………
Email ID ………………………………………………………………………………………
