Application for Leave Form
for 2MBS Staff
Please complete and submit this form
/
Day
/
Month
Year
Full name
First Name
Last Name
Email address
*
example@example.com
Type of leave
Please tick the appropriate box for the type of leave you are requesting
*
Annual
Personal (Eg sickness; bereavement; emergency)
Miscellaneous [paid (e.g Jury service]
Time in Lieu
Long service
Have you obtained a medical certificate?
*
Yes
No
Reason/s for leave request
*
Period of leave
First day of leave
*
Last day of leave
*
Total number of leave days or hours requested
*
Notes
Submit
Should be Empty: