Employee Leave Application Form
Name
First Name
Last Name
Email
example@example.com
Today's Date
-
Day
-
Month
Year
Date
Details of Leave
From (First Day Off)
-
Day
-
Month
Year
Date Picker Icon
To (Last Day Off)
-
Day
-
Month
Year
Date Picker Icon
Leave Type
*
Annual Leave
Sick Leave
Bereavement Leave
Jury Service
Medical Certificate Upload
Browse Files
If on sick leave for 3 days or more - please upload a copy of the medical certificate
Cancel
of
Comments
Paid or Unpaid Leave?
Paid
Unpaid
Employee Signature
*
Request Leave
Manager to Complete
Approval Status
Approved
Denied
Comments
Managers Signature
Send to Payroll
Payroll to Complete
Employee's Leave Balance
Leave is:
Approved
Declined
This will be:
Paid
Unpaid
Send to Employee
Should be Empty: