LAAS | Application For Leave Form

Application for Leave Form – QF220

Employee Details
Name*
Position:*
Email*
Phone Number*
Leave Type
Please tick the appropriate box(es).*
- Annual leave (full pay)
- Annual leave (half pay)
- Personal leave
- Time off in lieu (advise days/ hours you are claiming in comments section)
- Compassionate leave
- Parental Leave
- Leave without pay
- Long service leave
If you are applying for more than one type of leave, please specify the details in the comments section provided.
Comments:
Period of Leave
Last Day of Work:*
MM slash DD slash YYYY
First Day of Leave:*
MM slash DD slash YYYY
Return to Work Date:*
MM slash DD slash YYYY
Total number of working days:*

*Do not include Public Holidays in the total
Please indicate if you would like to be paid half pay or full pay:*
- I hereby confirm that all my responses to the above questions are true and correct.

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