Leave Request Form

Leave Request Form
Name*

First NameLast Name
Department*
Department Head Name
Leave Entitlement Days (2024)*
Total leave days allocated to the employee for the year 2024.
Leave Entitlement Days (2025)*
Total leave days allocated to the employee for the year 2025.
Total Work Days Off*
Leave Starting Date*

DayMonthYear
Date
Leave Ending Date*

DayMonthYear
Date
Duty Resumption Date*

DayMonthYear
Date
Address while on leave*
Contact number during leave*

Country CodePhone Number
Duties & Responsibilities Handover to*
Note: Please ensure that your job duties and responsibilities are handed over to the appropriate person before submitting this leave request form.

Also, kindly note that the form should be submitted to your department head at
least 30 days prior to the requested leave dates.

Thank you for your cooperation.
Should be Empty: