Leave Application Form Employee Details First Name(s) * Last Name * Position Held * Employee Email Address * Contact Number Date Applied * Period Requested Leave From * Leave To * Total Number of Leave Days Requested * Type of Leave Select the type of leave requested * Annual LeaveSick LeaveFamily Responsibility LeaveUnpaid LeaveInjury on Duty (IOD)Other If you selected “Other”, please describe the type of leave: Reason for Leave Additional Comments or Notes Supporting Documentation Is a doctor’s note applicable to this application? YesNo Upload Doctor’s Note or Supporting Document Accepted formats: PDF, JPG, PNG, DOC and DOCX. Maximum file size: 10 MB. Employee Declaration Please confirm the declaration below before submitting the application. I confirm that the information supplied in this leave application is true and correct. I understand that submitting this form does not mean that the leave has been approved. Employee’s Full Name as Electronic Signature * Your Private Email Address * Confirm Your Private Email Address * Date Signed * Form version: 20260529
