Staff Leave Form

• Conducted on

  Date

• Prepared by

• Date

  Date

• Employee number

• Name and Surname

Leave type

• How many days of this type of leave do you have left for the year?

• What type of leave are you applying for?

  Select Annual Sick Unpaid Family Responsibility Maternity Paternity Unpaid Study Union Injury on Duty Compasionate

  • Annual
  • Sick
  • Unpaid
  • Family Responsibility
  • Maternity
  • Paternity
  • Unpaid
  • Study
  • Union
  • Injury on Duty
  • Compasionate

• Date of Joining the Company

  Date

• Balance from previous year brought forward

• How many days do you have in lue of this type of leave

Period required

• From:

  Date

• To

  Date

• Both days inclusive

• Yes

  No

  N/A

• Number of working days (Excluding weekends wnd Public Holidays)

Contact information during Absence

• Add location
  Address

• Telephone number where you can be reached

Request for Approval

• Signature of Aplicant

  Sign

• Endorsed by Direct Supervisor

  Sign

• Approved by Manager

  Sign

• Select date

  Date