LEAVE APPLICATION FORM
It is condition for all leave granted that it is subject to be rescinded at any time by the Management. If it is
desirable in the interest of the company that the employee should continue to perform his/she has duties of
should return for duty before expiry of the period for which he/she has been granted leave.
PART A : TO BE COMPLETED BY EMPLOYEE
Name : Date Joined :
Department : Position :
Date Applied form : to :
No. of days (excluding Rest Day/PH) :
To report for duty on : Contact no. during leave :
Reason for application :
Person who relieves duty during absence of leave :
TYPE OF LEAVE APPLIED (Please Tick)
Annual Leave ( ) Leave brought ( )
Advance / Unpaid Leave ( ) ADD : Current year leave ( )
Maternity Leave ( ) SUBTOTAL ( )
Marrimonial / Compssionate Leave ( ) LESS
Medical Leave ( ) Leave taken up to date ( )
Leave applied now ( )
Annual leave balance (as at Dec) ( )
Employee’s Signature : Date :
PART B : FOR MANAGEMENT
Recommended / Not Recommended Approved / Not Approved
DEPARTMENT HEAD GMD/GED/ED/GM/SM/AM/OM/CM
Date : Date :
PART C : TO BE RETAINED BY EMPLOYEE AFTER APPROVAL
Name your application for annual / Not Pay Leave / Exam / Maternity / Paternity /
Compassionate / Marriage Leave form to has been approved / not approved.
Leave Detail ( )
Brought Forward ( )
Current Leave ( )
Leave taken up to-date ( )
Annual Leave Balance ( )
Leave to be cleared by end of December ( )
N.B. Except emergency cases, all leave MUST be applied at least a week in advance.