请假条的事项范文通用20篇

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请假条的事项范文 第一篇

尊敬的xxx老师:

一年x班学生xxx因为感染病毒,不能到校学习,故于xxxx年xx月xx日当天请假一天。

而xxx同学本人于xx月xx日正常离校后,将于下学期开学时准时到校,不会延误。

在假期里我作为学生家长,一定会对 同学严格要求,教育她:

一、注意交通安全,不在马路上跑闹,不随意横穿马路,遵守交通规则,文明行车

二、注意用电安全,不碰插头、电线和灯头等

三、注意用火安全,不玩火不碰煤气,观看烟花有大人陪同

四、加强自我保护意识

如若在假期中发生意外,由家长本人承担相关责任。

鉴于以上,恳请老师准假。

敬礼!

请假人:

时间:

请假条的事项范文 第二篇

请假条用英文怎么说

an excuse

written request for leave

参考例子一

dear ,

i would like to know if i could ask for a casual leave of absence from youroral english class this wednesday morning.

yesterday evening i got a phone call from my cousin, who is now running asmall firm in suburbs of this city . he needs an interpreter for two days butcannot find the most reliable person, so he wants me to have a try. personally ,i regard this as a golden opportunity to put what i have learned in your classinto practice, but i need your permission of absence . if you think i may go andhelp him get over the difficulty, i am confident that i ll do a good job andboth of us will grateful.

earnestly yours,

xxx

参考例子二

dear _ _ _:

hello! i am _ _ _ level _ _ _ professional _ _ _ _ _ _. because of _ _ _ _ _ _ _ _ _ ( excuse ) cannot _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. we take. please approve.

sincerely yours

leave: _ _ _ _ _ _

x month x day

参考例子三

dear mr. smith,

i would like to apply for an annual leave from january xxth to xxst.

as you may know the spring festival is falling on february 1st this year. it's the most important holiday in china and offers the best occasion for family reunion. however, over the past 3 years i missed the reunions due to tight work schedule. now that i have wrapped up my work for this year, i would like to go back to my hometown to pay filial piety to my parents and help my sole brother prepare his wedding on january xxth.

it's indeed double happiness for my family that i would like to be part of. coupled with the official holidays for the spring festival, i will have two weeks off which will definitely gear me up for better work in the new year. i'm looking forward to your kind answer.

best regards,

xxx

请假条的事项范文 第三篇

dear mr chen,

i'm sorry to tell you that i can't go to school today. i've caught a cold because i swam in the kunming lake yesterday.[转

this morning i had a headache. after taking my temperature, my mother found that i had a high fever. she took me to see a doctor. the doctor advised me to stay in bed for two days.

英语请假条范文一

Dear Mr/Ms ;

Today I'm writing to you to ask for a five-day leave, for I've got cold last night with carelessness.

This morning my mother took me to see the doctor, who told me to stay in bed for some days. So I am very sorry to be absent from school, especially your interesting lessons. I'll be sure to make up for the missed lessons after I recover from the illness.

Yours ever,

尊敬的先生/女士;

今天我向您请一天假,因为我昨天晚上不小心感冒。

今天早上,我妈妈带我去看医生,医生告诉我要在床上呆几天。所以我很抱歉没有从学校,特别是你有趣的课。我从病中康复后,一定会弥补错过的课。

你永远的朋友,

英语请假条范文二

你叫李铁,20xx年10月21日向英语老师江老师请假。

内容:由于感冒今天不能来上1,2节的英语课。昨天淋了雨。晚上发烧,医生建议休息一两天,身体恢复后会立即去上课。请批准为盼。英语课结束后会给老师打电话。附上医生的证明。

Dear Mr/Ms Jiang

I was unable to come to 1st and 2nd period to the rain yesterday, I was wet and had temperature at night. The doctor adviced me to rest for several days and after my recovery, I will attend school as soon as possible.

英语请假条范文一

an application for annual leave

to: mr. john smith, general manager

from: george chen, accounting department

date: january 22,

subject: application for annual leave

dear mr. smith,

i would like to apply for an annual leave from january 25th to 31st.

as you may know the spring festival is falling on february 1st this year. it's the most important holiday in china and offers the best occasion for family reunion. however, over the past 3 years i missed the reunions due to tight work schedule. now that i have wrapped up my work for this year, i would like to go back to my hometown to pay filial piety to my parents and help my sole brother prepare his wedding on january 28th.

it's indeed double happiness for my family that i would like to be part of. coupled with the official holidays for the spring festival, i will have two weeks off which will definitely gear me up for better work in the new year. i'm looking forward to your kind answer.

best regards,

篇一

Asking for Business Leave

December 8, 20_

Dear Head Teacher Zhang,

A telegram has just reached me saying that my father is seriously ill and urging ① me to go home at once. Because of this I would like to have a leave of two days beginning on the next day(December 9). I hope that my request will be given due consideration②.

Yours truly,

Zhao Jianqiang

Encl. : a telegram from my home

篇二

Dear Miss Gao,

I'm sorry I can't go to school today. I helped the farmers pick apples with my classmates on the farm yesterday. Unluckily, I fell off the ladder and hurt my leg, but I wasn't badly hurt. The doctor asked me to stay in bed and have a good rest. So I ask for leave for two days.

Wang Li

篇三

To: Jerry More ,Manager

From :Qiu Tian ,Sales Department

Date: Mary 11th, 20_

Subject: Casual Leave of Absence

Jerry ,I would like to know if I could ask for a casual leave of absence for one day on May 18th .

This morning I received a letter from a friend of mine, inviting me to attend his wedding ceremony which will

take place next Friday,May 18th . I am so pleased to learn this good news that I can not wait to see my best friend become the happiest groon in the world .

英语作文请假条范文一

Dear Mr. Smith,

I am really sorry to tell you that I cannot attend the training course next Tuesday, because ny manager has appointed me to go on a 3-day business trip to Hainan. Will you please record the lecture for me to review later?

Thank you for your consideration.

Yours faithfully,

Li Ming

英语作文请假条范文二

dear mr/ms ;

today i'm writing to you to ask for a five-day leave, for i've got cold last night with carlessness.

this morning my mother took me to see the doctor,who told me to stay in bed for some days. so i am very sorry to be absent from school, especially your interesting lessons. i'll be sure to make up for the missed lessons after i recover from the illness.

yours ever,

英语作文请假条范文三

Dear Mr/Ms ;

Today I'm writing to you to ask for a five-day leave, for I've got cold last night with carlessness.

This morning my mother took me to see the doctor,who told me to stay in bed for some days. So I am very sorry to be absent from school, especially your interesting lessons. I'll be sure to make up for the missed lessons after I recover from the illness.

请假条,是请求领导或老师或其它,准假不参加某项工作、学习、活动等的文书。关于英语请假条范文具体内容请看下文。

关于英语请假条范文50字

dear ms. ma

i am sorry to tell you that i can\'t go to school today last night my mother had a high fever and a bad cough perhaps she has caught flu i will take my mother to tiantan hospital and then look after her at home so i couldn\'t go to school today so i would like to ask for one day\'s leave i will be very grateful if you grant my leave

首先,假条的基本信息还是和中文的格式一样的,包含了以下信息:

to:假条是递给谁的

from:请假人

date:写假条的日期(注意不是请假的日期)

subject:主题(写上请假字样)

举例:

to: matthew zhang, manager

from: tina xu, marketing department

date: august 6,

subject: casual leave of absence

其次,在请假信第一段,应该开门见山地提出请假。第一段要中心明确,写清您要请假的日期。

比如:matthew , i would like to know if i could ask for a casual leave of absence for one day on august8 ,this friday.

然后,在假条的第二段,您应该简单明了陈述请假的原因事由。注意叙述清楚明白,并尽可能表示对此带来工作不便的歉意。

你可以写:

this morning i received a telephone call from my dentist, urging me to come to his practice for immediate treatment of my teeth. i have been experiencing a stinging pain,depriving me of my sleep during the past fortnight. the situation could worsen,should infection occur.

concerning my workload: as friday is not as busy as the other weekdays, i think a one-dayleave this friday may be the best solution. i apologize for the inconveniencemy absence from work may cause.

英语请假条范文

根据以下信息,写一份病假条:

你叫,20xx年10月21日向英语老师江老师请假。

内容:由于感冒今天不能来上1,2节的英语课。昨天淋了雨。晚上发烧,医生建议休息一两天,身体恢复后会立即去上课。请批准为盼。英语课结束后会给老师打电话。附上医生的证明。

关键词:证明:certificate

dear mr/ms jiang

i was unable to come to 1st and 2nd period to the rain yesterday, i was wet and had temperature at night. the doctor adviced me to rest for several days and after my recovery, i will attend school as soon as possible.

dear mr. li,

i was caught in the rain yesterday and i had a fever last am really not feeling well now. my mom will take me to see the doctor .please excuse me for not attending school today thank you!

li hua

taking a leave of absence.

the distinguished leadership of the company:

i am in the x month x day marriage registration, and belongs to the late marriage. according to the relevant state provisions of marriage, i can enjoy 15 days of marriage. it is special to the leadership of requests take marriage holiday, from x x to x x, a total of 15 days, please approve.

i hereby apply for

applicant:

x month x day

taking a leave of absence

company leader:

i have a boyfriend and agreed to the * * * * wedding, from the * * * * * days as of the date of leave, your approval.

leave: * * * * * * *

year, month and day

general company leader requirements after the marriage certificate after marriage to please, but must be issuing after half a year to a year to break off, otherwise expire, but these regulations is also the company leadership, you can go to ask the hr colleagues, if can humanize some, it is not worry so much, if not only to separate please.

i am in the _ _ _ _ years _ _ _ _ month _ _ _ _ days pre-production, recommended by a doctor, to the years _ _ _ _ month _ _ _ _ days ahead of labor, especially from _ _ _ _ month _ _ _ _ began to leave, for a period of _ _ _ _ _ days, please lead to approve, thank you!

applicant.

_ _ _ _ years _ _ _ _ month _ _ _ _ day

because of events or disease no school or to work or participate in activities, to the related personnel leave a note, taking a leave of absence or call to call.

note format by the title, name, text, several components, specific writing methods are as follows:

title:xxx excusexxx three words written in the first line of the middle position.

address: second lines written in the top who to leave. write receipt addrea person with the general epistles. are generally to the boor the teacher for leave. the specific wording in the surname followed by position, such asxxx director chenxxx,xxx king section chiefxxx,xxx zhangxxx, use a colon after.

abstract: writing clear off this, leave the starting and ending time. in the third line two write. finally, often toxxx please leavexxx,xxx best regardsxxx,xxx gratefulxxx wait for diction end.

inscribe: sign and date the same general epistles. in the lower right on leave name. the name below the mark of date of leave.

请假条的事项范文 第四篇

本人_____,现就读于____学院_____班,学号______,宿舍号:______。家庭详细地址(仅限盐城本市同学):_____________________,因离家较近申请每周末回家,时间从______至______(从第__周开始)

本人承诺:

1、在离校期间遵纪守法,保证往返途中的个人人身和财产安全,且自行承担一切后果;

2、诚实守信,此假条中不存在虚假之处,严格按照假中的时间段离校并按时返校,离校期间,确保信息通畅;

3、本假条仅限周末无课时使用,对请假时段内所有上课安排(包括实验及实习课程、临时调课课程)无效;

4、周末如果有课,保证做到不迟到、不早退、不缺席;

5、严格遵守学校及我院住宿生的相关管理规定,周日晚10:00前必须返校;

6、本假条一式三份,学生处留存一份,宿管中心一份,学生留存一份,经辅导员签字,学生科盖章后生效。

7、如遇特殊情况,请第一时间主动与本班辅导员联系。

家长签字:__________联系号码:__________

__________年_____月_____日

辅导员意见(签名)

(学生科盖章)

__________年_____月_____日

请假条的事项范文 第五篇

老师:

我因病请假两天,但仍未痊愈,还不能上学,需要继续治疗,只好再续假两天,望能批准。

敬礼!

学生:

年月日

正确格式:

标题:居中写《请假条》,用来表明此文是用来请假的。

称呼:平时怎么称呼,这里就怎么写,后面加冒号。这个地方往往是领导、相关负责人等。

正文:请假理由。直接写请假的原因,起止时间。如果有什么事要交代,也可以在写完请假原因之后接着写要交代的事情。正文写完后要加祝颂语,祝福对方,这个是所有公文里表示对对方的友好。

署名:写在正文下右下方第三行处。如果是学生向老师请假,在名字前面加上学生二字。

日期:写在署名下面,另起一行。也可以不写年,最好在月日下面写上上午或者下午,也可以写上时分,必要时加上地点。

写作要求:请假条最重要的内容是写明请假原因和日期,一定要写明确,不能只写因有事请假。

请假条的事项范文 第六篇

尊敬的领导:

您好!!

本人(姓名),于**年**月入司,在公司的工作这段时间,本人深深被单位的企业文化所吸引.受公司企业文化的熏陶,本人深知,作为一个年青人,除了工作,仍然需要不断地学习,充电,以便个人潜力提高,为自己将来职业身崖规划打下坚实的基础.所以,本人于**年**月参加了会计资格证书的培训,将于**年**月考试,出于每次培训时间为每周星期天,所以本人现申请在本人培训的这段期间(注名具体时间)内,如公司不是很忙的状况下,本人周末能够不用加班!当然,如果因公司有紧急事宜或任务须处理,本人将以工作为重,第一时间赶到公司!

盼望领导能给我一个学习的机会!!!!谢谢!!!

望领导批准!!!谢谢!!

申请人:

日期:

请假条的事项范文 第七篇

篇一:公司请假条范文

请假条怎么写 (另附英文范文)

但无论是邮件版的请假条还是文档版的请假条,在其写法上,必须包含的内容主要有:请假受理人(或部门)、请假事由、请假具体时间、请假人、请假日期这五大项。

首先,请假条的写法: 写请假条需要注意下述事项: 1、时间上:提前写 要请假,提前写请假条几乎是所有企业对员工请假的明文(或默认)要求;

请假条(居中)

受理请假的人或主管部门(称谓,如王经理或人力资源部,注意顶格)

请假人:xxx(请假人签名) ____年____月____日(请假日期)

其次,请假条范文:

一、请假条范文

★★范例一(请事假) 1、请长事假

请假条

xx部

请假人:xxx

____年____月____日

2、请缺席会议假

请假条

xx部长:

请假人:xxx

____年____月____日

3、 请缺席活动假

请假条

xx培训中心:

请假人:xxx

____年____月____日

★★范例二(请产假):

请假条

xx部:

本人于____年____月____日的预产期,经医生建议,定于20_年____月____日提前待产,特从20_年____月____日开 始请假,期限为_____天,请领导予批准,谢谢!

申请人:xxx

____年____月____日

★★范例三(请病假)

请假条

xx部:

我因感冒发高烧,需要输

请假条的事项范文 第八篇

本人_____,现就读于____学院_____班,学号______,宿舍号:______。家庭详细地址(仅限盐城本市同学):_____________________,因离家较近申请每周末回家,时间从______至______(从第__周开始)

本人承诺:

1、在离校期间遵纪守法,保证往返途中的个人人身和财产安全,且自行承担一切后果;

2、诚实守信,此假条中不存在虚假之处,严格按照假中的时间段离校并按时返校,离校期间,确保信息通畅;

3、本假条仅限周末无课时使用,对请假时段内所有上课安排(包括实验及实习课程、临时调课课程)无效;

4、周末如果有课,保证做到不迟到、不早退、不缺席;

5、严格遵守学校及我院住宿生的相关管理规定,周日晚10:00前必须返校;

6、本假条一式三份,学生处留存一份 ,宿管中心一份,学生留存一份,经辅导员签字,学生科盖章后生效。

7、如遇特殊情况,请第一时间主动与本班辅导员联系。

家长签字:______________联系号码:______________

x年xx月xx日

辅导员意见(签名)

(学生科盖章)

x年xx月xx日

请假条的事项范文 第九篇

受理请假的人或主管部门(称谓,如王经理或人力资源部,注意顶格)

我因(请假原因:事因、病因等原因,简单陈述即可),于____年____月____日至____年____月____日(请假起止时间),请假____天(请假具体时间),请批准(请假辞)。

请假人:XXX(请假人签名)

____年____月____日(请假日期)

一、请假条范文

★★范例一(请事假)

1、请长事假

请假条

XX部

我因大学毕业答辩事宜,答辩最终结束时间为20 年5月18日,第二专业答辩结束时间为20 年5月24日,由于准备毕业论文及答辩工作,需请假____天,请批准。

请假人:XXX

____年____月____日

2、请缺席会议假

请假条

XX部长:

我是XXX,由于_____的原因不能来参加___周的'____会议,望主席和大家谅解。

请假人:XXX

____年____月____日

请假条的事项范文 第十篇

我是______班______,住______楼_______宿舍

家住________________________。

经家长同意周末回家。本人承诺,周末回家并在相关位置签名确认,否则责任自负。

申请人:____________申请日期:______________

家长确认签字:____________辅导员意见:____________

请假时间段:第______周至第______周。

说明:

1、本假条仅用于家住徐州市区的学生,周末请假起止时间为周五晚至周日下午。

2、本假条须有家长亲自签字同意,方可办理,院学生工作办公室盖章后有效。

3、本假条批准生效后,不得转借他人使用,如被发现立刻予以收回,并给予相应处分。

4、本假条仅限周五晚、周六、周日无课时使用,对请假时间段内所有教学安排无效。

5、根据《学生伤害事故处理办法》相关规定,学生在回家期间若发生任何意外或事故,一律由学生本人和家庭承担,与学校无关。

6、本假条黏贴在学生宿舍床头卡附近,方便检查。

此处盖章有效

请假条的事项范文 第十一篇

尊敬的______老师:

您好!

您的学生________因______________________需请假__________学时,望老师批准。

(请假日期:__________年_____月_____日至__________年_____月_____日)

请假人:______________

_____________________学院 _______________________(班级)

__________年_____月_____日

班主任:(签字)________________________________

学办:(签字、盖章)________________________________

学院签字:签字________________________________

备注:请用整张信纸,按照以上格式黑笔书写,一式二份,三天以上学院领导签字。

请假条的事项范文 第十二篇

Dear Mr. Wang,

I am very sorry that I shall be unable to come to your classes today owing to a bad cold. I enclose a certificate from the doctor who is attending me. He said it will be two or three days before I shall be able to resume my school.

David

April 20

请假条英语02-04

英语请假条01-20

请假条的事项范文 第十三篇

xx市教育局:

本人__________,性别____,现年______岁,________年____月参加工作,现是______镇______________校园(公办、代缺)教职工。

□1、病假:经医院诊断为____________________________,需请假治疗。

□2、请事假理由:_______________________________________________。

□3、产假。第____胎,预产期为_______年_____月。

请假从______年____月____日起至_________年____月____日止共_____天。

请批准。

附件:

①病假、剖腹产假务必出具市级医院(xx市人民医院、中医院、妇幼保健院)证明。

②49周岁以下已婚女教职工务必出具有关计生证明复印件(中学或中心小学审核盖章)。

申请人:______________

_________年____月____日

请假条的事项范文 第十四篇

请假条

张老师:

今天,我因感冒发烧,不能到校上课,请假一天,请予批准!

请假人:xx

20xx年x月x日

请假条

老师:

我因昨日感冒发烧,现在体温仍达39°c,故今天不能来上学,请准假一天为盼。

请假人:xx

20xx年x月x日

请假条

xxx:

兹有本班学生xxx,因xxxx(病因)需休息治疗,现请假xx天,希批准为感!

请假人:xx

20xx年x月x日

请假条

老师:

昨天我在放学回家的途中被雨水淋了患了感冒并咳嗽,医生建议在家休息,因此需请假两天(xx月xx日至xx月xx日),请予批准。

请假人:xx

20xx年x月x日

请假条

尊敬的x老师:

我今天给您写信是要请5天的假,因为我昨天晚上不小心感冒了。今天早上,我妈妈带我去看了大夫,大夫告诉我要在家里躺几天。所以,我对缺课,特别是不能上您那有趣的课,感到难过。我病好后一定把漏掉的课程补上。

请假人:xx

20xx年x月x

请假条的事项范文 第十五篇

尊敬的系领导:

本人计划在年月日至年月日期间到省市实习,在请假期间本人作出如下承诺,并保证严格履行。

一、本人的毕业论文(设计)已经选好题目,题为:指导老师为:

由于外出实习,本人制定了详细、可行的完成毕业论文(设计)的计划。计划附后,并有指导老师的签字。指导老师同意我的计划,也同意了我在外出实习的同时完成论文、设计。如果由于本人不及时与指导老师联系而导致毕业或毕业论文(设计)受到影响或外出后毕业设计(论文)跟不上进度,其后果将由本人负责。本人实习单位名称为:其负责人联系方式为:

二、保证每周至少与指导老师联系一次,本人的家庭电话为:;本人的手机号码为:。电话如有变动,保证及时告知班主任和指导老师。本人的e—mail是:qq号是:

三、本人保证家长已经知道本人承诺的详细内容,本人外出找工作也已经得到家长的同意。家长于年月日给班主任打电话,表示同意的意见大学生实习请假条请假条

家长的名字是,家长的联系方式为:

四、本人保证外出期间不做违法乱纪的事情,外出期间自行负责自身的生命、财产安全问题。保证在年月日前安全回到学校。

五、本人外出的目的是尽快就业,所以本人承诺:在毕业答辩前一定签订就业协议书或者拿回单位的录用证明。

特向领导请假,请批准。

本请假条一式三份,指导老师、班主任、学生本人各一份。

本人签名:

年月日

指导老师意见

班主任意见

系领导意见

请假条的事项范文 第十六篇

dear mr/ms xxx,

today im writing to you to ask for a five-day leave,for ive got cold last night with carlessness. this morning my mother took me to see the doctor,who told me to stay in bed for some days.

so i am very sorry to be absent fromschool, especially your interesting lessons. ill be sure to make up for the missed lessons after i recover from the illness.

xxx.

请假条英文07-15

英文请假条08-10

请假条的事项范文 第十七篇

第一篇:婚假请假条格式及范文

尊敬的学校领导:

本人于xxxx年x月x日登记结婚,并属于晚婚。根据国家有关婚假规定,本人可享受15天婚假。现特向领导请求休婚假,自x月x日到x月x日共计15天,请予以审批。

特此申请

申请人:xxx

xxxx年x月x日

第二篇:婚假请假条格式及范文

尊敬的_______________:

您好!我是余坊中心校的教师_________,因为_______________________,需请______请假。(时间)从_______到_______,去往地点__________________,请假期间有效联系方式:_________________。恳请批准,谢谢

敬礼!

请假人:_____________________

时间:_______年______月_____日

校方(校长)意见:

教育局(直属领导)意见:

第三篇:婚假请假条格式及范文

尊敬的公司领导:

本人于xxxx年x月x日登记结婚,并属于晚婚。根据国家有关婚假规定,本人可享受15天婚假。现特向领导请求休婚假,自x月x日到x月x日共计15天,请予以审批。

特此申请

申请人:xxx

xxxx年x月x日

第四篇:婚假请假条格式及

请假条的事项范文 第十八篇

不小心感冒了,大家会怎样写自己的请假条呢?下面我们来看看关于感冒请假条,欢迎阅读借鉴。

x老师:

昨天我在放学回家的途中被雨水淋了患了感冒并咳嗽,医生建议在家休息,因此需请假两天(xx月xx日至xx月xx日),请予批准。

敬礼!

学生:xxx

xxxx年xx月xx日

×老师:

我昨天晚上睡觉着了凉,早上起来头疼,还有点感冒发烧。上午我要去看病,请假半天,请批准。

此致!

敬礼!

您的学生:×××

×月×日

x老师:

我因昨日感冒发烧,现在体温仍达39°c,故今天不能来上学,请准假一天为盼。

学生xxx

x年x月x日

xx老师:

今天,我因感冒发烧,不能到校上课,请假一天,请予批准!

学生xxx

x年x月x

请假条的事项范文 第十九篇

尊敬的老师:

我是_____级__________班学生_______________学号_________________________因________________________________________原因,需请假_____日,从_____年月日_____(星期_____)到_____年月日__(星期_____)。特恳请老师批准!

请假申请时间:____________________实际销假时间:____________

班主任签名:________________辅导员签名:________________

系领导审批:________________分管院领导审批:________________

请假条的事项范文 第二十篇

尊敬的_______________:

您好!我是中心校的教师_________,因为_______________________,需请______。请假(时间)从_______到_______,去往地点__________________,请假期间有效联系方式:_________________。恳请批准,谢谢

敬礼!

请假人:_____________________

时间:_______年______月_____日

校方(校长)意见:

教育局(直属领导)意见:

写一则请假条 篇3

尊敬的______老师:

我是_____________初高______级_____班学生__________,因_____________________,特向您请假___________(多久),请假时间为_______年____月_____日_________至__________。离校期间一切安全责任由我(学生本人)自负,请您准假!

__年x月x日

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