Leave Request Form

Leave Request Form
SECTION 1 - LEAVE REQUEST DETAILS
To be completed by employee
Name:*

First NameLast Name
Email:*
First Date of Leave:*

DayMonthYear
First day of leave
Last Date of Leave:*

DayMonthYear
Last day of leave
Select your Manager:*
Type of Leave:*

Annual LeaveSick & Carers LeaveBereavement LeaveJury DutyLeave without payMaternity/Parental LeaveLong Service LeaveOther
Reason for leave:*
Please make sure you have read the relevant leave policy before you apply. These can be found here. Note that if you are applying for personal/carers leave you may need to submit a medical certificate. If this certificate is not submitted by the time payroll is processed then it will be processed as annual leave or unpaid leave and your manager will be notified.*

I have read the relevant policy and will submit a certificate if necessary