Boekeman Machinery Northam Leave Application Form

Boekeman Machinery Est 1968
LEAVE APPLICATION
Employee Name*
Email
example@example.com
First Day of Leave*

DayMonthYear
Date
Hour MinutesAM/PM Option
Last Day of Leave*

DayMonthYear
Date
Hour MinutesAM/PM Option
Leave Required

Annual LeaveSick LeaveCarers LeaveLong Service LeaveR&R (1 Week - Staff 5+ Years)Leave Without Pay (LWOP)Other
Comments about leave requested
Total Leave Days / Hours
Days or Hours
To be approved by Department & Branch Manager.

Dealer Principal to also approve annual leave in April, May, June, October, November & December. A/L must be requested well in advance for these months. Leave may not be approved so please do not make holiday arrangements until all Managers have signed.

A Doctors Certificate must be provided for 2 or more consecutive days of Sick or Carer leave taken on a Monday, Friday or either side of a Public Holiday.
Doctor Certificate Provided
Attached Medical Certificate

Cancelof
Employee Signed*

Clear
Date*

DayMonthYear
Date
Should be Empty:

Boekeman Machinery Est 1968