Holiday Request Details

DO NOT BOOK ANY HOLIDAYS WITHOUT THE PRIOR APPROVAL OF A MANAGER
Requests are NOT APPROVED until this form has been returned to you with approval from a manager
If you do not receive your approved request form back within 10 working days contact to the office

Number of days requested to be absent from work

Last working date before holiday commences
Date of return to work

Dates of holiday

Date from:
Date to:
Employee name and signature

THE FOLLOWING BOXES ARE FOR OFFICE USE ONLY

Managers approval YES NO

Date of Approval

Managers Signature

Date returned to employee

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.