Leave Application And Approval Form
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1Leave Application and Approval Form
Employee Details
Centre:
Staff Name:
Leave Type
I wish to apply for the following type(s) of leave (please tick):
Annual Leave
Long Service Leave
Personal / Carer’s Leave
Community Service Leave
Compassionate Leave
Other: ___________________________
Documentation attached? (please circle) Yes / No
If multiple types of leave are applied for, please specify:
Period of Leave
Last Day of Work:
Return to Work Date:
Total Number of Hours of Leave Requested:
My most recent payslip leave balance was
recorded as:
Comments
Signature of employee:
Date:
/
/
______________________________________________________________
__________
____________
___________
Approval of Leave (to be completed by a Committee Member)
Approved
Not Approved
Reason for Refusal (if applicable)
Signature of Committee Member:
Date:
/
/
________________________________________________
__________
____________
___________
Name:
_____________________________________________________________________________________
Position:
__________________________________________________________________________________
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Parent category: Business