ANNUAL LEAVE & SICK LEAVE FORM

ANNUAL LEAVE & SICK LEAVE FORM
Please fill in form below. Only 1 week per form, so if you are applying for more than 1 week you will need to submit another form

TYPE IN "0" IF SOMETHING DOES NOT APPLY
Name *

First Name Last Name
Email Address you would like a copy of this sent to *

Confirmation Email example@example.com
PLEASE SELECT - How many days leave (whether paid or unpaid for the week) *

1 day 2 days 3 days 4 days 5 days
DATE 1 *

Day Month Year
Date
PLEASE SELECT ALL THAT APPLY FOR THIS DATE 1 *

Hours worked Paid Annual Leave Unpaid Annual Leave Sick Leave (includes isolation for negative covid tests) Covid Isolation (for positive tests only) Bereavement Leave (immediate family only)
Hours worked today *
Paid Annual Leave Hours *
Unpaid Annual Leave Hours *
Sick Leave Hours (includes isolation for negative covid tests) *
Covid Isolation Hours (positive test only) *
Bereavement Leave (immediate family only) hours *
DATE 2 *

Day Month Year
Date
Hours worked today *
Paid Annual Leave Hours *
Unpaid Annual Leave Hours *
Sick Leave Hours (includes isolation for negative covid tests) *
Covid Isolation Hours (positive test only) *
Bereavement Leave (immediate family only) hours *
DATE 3 *

Day Month Year
Date
Hours worked today *
Paid Annual Leave Hours *
Unpaid Annual Leave Hours *
Sick Leave Hours (includes isolation for negative covid tests) *
Covid Isolation Hours (positive test only) *
Bereavement Leave (immediate family only) hours *
DATE 4 *

Day Month Year
Date
Hours worked today *
Paid Annual Leave Hours *
Unpaid Annual Leave Hours *
Sick Leave Hours (includes isolation for negative covid tests) *
Covid Isolation Hours (positive test only) *
Bereavement Leave (immediate family only) hours *
DATE 5 *

Day Month Year
Date
Hours worked today *
Paid Annual Leave Hours *
Unpaid Annual Leave Hours *
Sick Leave Hours (includes isolation for negative covid tests) *
Covid Isolation Hours (positive test only) *
Bereavement Leave (immediate family only) hours *
ANY NOTES e.g if for bereavement leave please explain here
DATE *
CLICK ON SUBMIT TO SEND YOUR LEAVE FORM THROUGH TO RACHEL
Should be Empty: