Leave Application Form
Employee Name: ID:
Job Title: Job Family:
Location: Date:
Annual entitlement: Days carried forward from last year:
Leave Type: Annual Leave Sick Leave Other, please specify:
* In case of Sick leave for three or more than three days, a valid medical certificate must be
attached with this form
Total entitlement
No. of
Details of leave being working days
requested
Details of leave taken No of working Date from To
already this year days
Total days taken this year including this
application
Total days remaining this year including this
application
Employee comments:
Employee contact information whilst on leave:
Employee’s Signature: Date:
Manager’s Signature: Date:
Manager’s Name:
Manager’s comments:
*Approved Leave form to be submitted to HR & Finance before going on leave.
*Approved only when signed by Manager.
* A copy of the approved form to be kept by the employee.