Leave Request Form
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1Leave Request
Details
Employer:
Employee’s Manager:
Employee’s Name:
Employee’s Signature:
Date:
Type of Absence
☐ Annual Leave
☐ Personal/Carer’s
☐ Compassionate
☐ Parental Leave
☐ Unpaid Personal/Carer’s
☐ Unpaid Leave
☐ Long Service Leave
☐ Emergency Services
☐ Defence Force
☐ Jury Duty
☐ Other (specify):______________________________________________
Reason for Absence
☐
☐
Medical certificate or other evidence provided:
Yes
No
Period of Leave
First day of leave:
Last day of leave:
Start time:
End time:
Number of working days:
Manager Approval
Comment:
☐ Approved
☐ Refused
Signed:
Name:
Date:
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Leave Application Form
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Parent category: Business