Leave Application Form

Employee Details

  • Name

  • Position Title

  • Employee Number

  • Division

  • Location

Type Of Leave

  • Personal Leave

  • Medical Certificate

  • Annual Leave

  • Annual Leave Amendment / Cancellation

  • Long Service Leave

  • Leave Without Pay

  • Parental Leave

  • Attach Relevant Documentation

  • Bereavement Leave

  • Attach Relevant Documentation

  • Other Leave

  • Attach Relevant Documentation

  • Detail

Period of Leave

  • First Working Day of Leave

  • Last Working Day of Leave

  • Date of Return to Work

  • Number of Working Days

  • Number of RDO's

  • Number of Public Holidays

  • Total Leave Days

  • Comments

  • Employee Approval

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