Leave Request Form Name (Staff Member)* First Last Date* DD slash MM slash YYYY Email* Name of manager to approve leave* First Last Type of Leave RequestedI wish to apply for:* Annual Leave Personal Leave (Sick / Carer's Leave) Compassionate Leave Other (e.g Parental leave, Jury Service etc - Specify) Reason for Leave (if applicable): Leave DatesFirst date of leave:* DD slash MM slash YYYY Last date of Leave:* DD slash MM slash YYYY Total Number of Days:*Date Back in Office* DD slash MM slash YYYY CommentsLeave Policy (Staff Member Agrees to the Following Checked Policies and Terms)Personal and Annual Leave All leave requests by the staff member must be directed to their direct manager who has the authority to approve it. This includes personal leave (including sick leave) or annual leave. To request personal leave (including sick leave) and annual leave, a staff leave request form must be submitted. Refer to Staff Leave Request Form.doc located in head office, or available upon request Personal and annual leave policies:* If a staff member applies for leave but is yet to accrue enough days for that leave type, the leave application will be deemed leave without pay If a staff member calls in sick, they must communicate directly with their manager as soon as reasonably possible (communicating this indirectly, either by leaving a message with other members of staff or sending an SMS, is not deemed as proper communication) Proof of illness (doctor’s certificate) is required for all absences of 4 hours or greater on any day of the week Managers should have their staff members’ contact numbers and vice versa, so that each party is easily contactable should someone be running late or become ill prior to commencing work Managers should expect ample advance warning when a staff member wishes to request significant periods of leave. These expectations should be communicated to staff by their manager. Paid Parental Leave As of January 1st 2011, employees are entitled to paid parental leave under a new government scheme, if their child is born or adopted on or after this date. Generally, paid parental leave will be for mothers of a newborn child or the parent of an adopted child. To be eligible for paid parental Leave, you must be the child’s primary carer and;* have worked continuously for at least 10 of the previous 13 months prior to the expected birth/adoption have worked at least 330 hours in that 10 month period (an average of 7.6 hours per week) your income must have been $150,000 or less in the previous financial year meet the scheme’s residence requirements have worked between the date of birth or adoption of the child and their nominated start date for paid parental leave. For complete eligibility and employer obligations for this government scheme please refer to this website: Paid Parental Leave Scheme (Source: www.familyassist.gov.au) Maternity Leave* Under current federal legislation, staff members are entitled to take up to 52 weeks of unpaid maternity leave. However at the agreement of both parties, the staff member may return to work sooner than this, or the leave may be extended. It is the manager’s responsibility to touch base with the staff member during their leave to see what their plans are with regard to returning to work. Employee Leave Request ConfirmationEmployee Signature*Manager SignatureOffice Use OnlyRecorded within Register
