离洛申请表

尊敬的领导：

Dear Sir/Madam,

本人想申请     年    月    日至    年    月    日离洛，前往        。

I would like to leave Luoyang for             （city）from           (mm/dd)to         (mm/dd), year of          .

事由：                                                                

Reason:                                                                

               .

离洛行程安排：

My itinerary for travel is as follows: 

目的地：

Destination:

交通工具：

Train/flight Number for Round Trip:

住宿：

Hotel:

我承诺离洛期间严格遵守中国政府相关法律、规章、制度,并承担一切相关责任！

I promise I will observe the laws, decrees and relevant regulations enacted by the Chinese Government and take all the responsibilities for myself on the trip.

此致敬礼

Sincerely yours,

签名                                       审批人:

Signature                                  Approved by:

                                           审批日期：