FT PT Crew Leave Request Form

Full Time & Part Time Crew Leave Request Form
Restaurant Name *
Name *

First Name Last Name
Email *
Phone Number *
Please enter a valid phone number.
Employment Type: *
Request Type *

Requesting Annual Leave Sick Leave Requesting Long Service Leave (Eligible 10+ yrs Service Only) Cash Out Leave Leave without Pay
Please Note:

Leave requests for longer than 2 weeks or that fall during School Holiday Periods must have strict written permission from your Business Manager. These impact the business and may not be approved.
Annual Leave From

Day Month Year
Annual Leave To

Day Month Year
How Many Leave HOURS are you requiring paid out? *
What Week Ending Date? *

Day Month Year
Please Note:

Long Service Leave is paid leave granted to an employee who has served a specified period of continuous employment.

Leave requests for longer than 2 weeks or that fall during School Holiday Periods must have strict written permission from your Business Manager. These impact the business and may not be approved.
Amount of Long Service Leave Days to be taken *
Long Service Leave From *

Day Month Year
Long Service Leave To *

Day Month Year
My Last Working Day will be: *

Day Month Year
Return to Work Date *

Day Month Year
To be Paid *
'Cash Out’ means you agree with Demi Pty Ltd to forgo taking a period of leave in return for a lump sum payment. Your annual leave will be reduced by the amount which has been cashed out. Must be in line with FFA guidelines.
How Many Days Are you requesting to be cashed out *
What Week-Ending Date? *

Day Month Year
Please Note:

Sick Leave needs to be submitted by 7am Monday morning
Dates were you sick? *
How many sick leave hours are you requesting *
You must attach your Doctor's Certificate to finalise your request *

Cancel of
What Week-Ending Date? *

Day Month Year
Leave Without Pay From *

Month Day Year
Leave Without Pay To *

Month Day Year
Are the above dates part of your agreed shifts? *
Reason for Leave Without Pay Request *
Do you have any Additional Information?
Signature *

Clear
Should be Empty:

Full Time & Part Time Crew Leave Request Form