Staff Leave Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please provide the centre with a minimum of two weeks’ notice for annual leave.
Leave application forms are to be completed for all periods of leave.
Leave application forms are to be retained on confidential files held at the centre.
Please email admin@gangabielc.com or bring a Medical Certificate if you are sick on a Public Holiday, or for more than 1 day at a time.

Email *

Employee Name *

Leave Type *

Annual Leave (AL)

Leave Without Pay (LWOP)

Sick Leave (S)

Compassionate Leave (CL)

Roster Day Off (RDO)

Long Service Leave (LSL)

Start Date *

IMPORTANT: Make sure to use the correct format as indicated, or use the date picker

YYYY

End Date *

(including last day - if you are leaving for a single day, the start and end date should be the same), IMPORTANT: Make sure to use the correct format as indicated, or use the date picker

YYYY

Total days of leave

Comments *

Reason for Leave (eg. Holiday, Time in lieu etc.)

Signature *

By checking this box, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.

Required

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Gan Gabi and Rivki Early Learning Centre. Report Abuse

Forms