Student weekend long-term leave note

I am ______, currently studying in class _ ____, student number __________; dormitory number: ____ bed number: _. Detailed home address (only for urban students): _____________ ____________, because it is close to home, I apply to go home every weekend (Friday night 19:00 ~ Sunday night 22:00), time: autumn semester

I promise:

1. I will abide by the law while away from school, ensure the safety of my personal life and property on my way back and forth, and bear all the consequences myself; 2. Be honest and trustworthy , there is no falsehood in this leave note. You must leave school strictly according to the time period in the leave note and return to school on time. During the period of leaving school, ensure smooth flow of information;

3. This leave note can only be used during weekends when there are no classes. All class arrangements during the leave period (including experimental and internship courses, temporary transfer courses) are invalid;

4. If there are classes on weekends, ensure that you will not be late, leave early, or be absent;

5. Strictly abide by the relevant management regulations of the school and our hospital’s boarding students, and must return to school before 10:00 on Sunday evening; 6. This leave will take effect after it is signed by the counselor and stamped by the Student Affairs Department; in triplicate, A copy of the parents' ID cards,

Each student, the dormitory management center, and the college's student department will keep one copy.

7. If you encounter special circumstances, please contact the class counselor as soon as possible.

Applicant’s signature: Contact number:

Parent’s signature: Father: Contact number:

Mother: Contact number:

Year and month Day

Counselor’s opinion (signature):

(Student Department’s seal) Year, month, day