LEAVE REQUEST FORM Name (Staff Member)* First Last Phone*Email* Leave TypeType of leave requested*PLEASE SELECT...Annual LeaveSick LeaveLeave PayoutUnpaid LeaveDoctor's certificate*Max. file size: 128 MB.You must attach a doctor's certificate for sick leave requests. Please scan or take a clear picture on your phone and upload here. Leave DatesFirst date of leave:* DD slash MM slash YYYY Last date of leave:* DD slash MM slash YYYY Total number of work days:*Date available to return to work (if applicable): DD slash MM slash YYYY Terms of Leave RequestTo request personal leave (including sick leave) and annual leave, a leave request form must be submitted in accordance with the terms below:* In the event of an application for leave where the Staff Member is yet to accrue enough days for that leave type, the leave application will be deemed leave without pay. Proof of illness (doctor’s certificate) is required for all sick leave requests. In the event of calling in sick, the Staff Member must communicate directly with his/her manager as soon as reasonably possible. Communicating this indirectly (leaving a third party message or sending an SMS) is not deemed as proper communication. In the event of requesting significant periods of leave or a leave payout, the Staff Member must provide minimum 2 week's notice. All leave requests must be approved by management. The Staff Member understands that is simply a request form and submitting this form does not constitute formal acceptance and approval of the leave. Employee Signature*Date submitted* DD slash MM slash YYYY
