LEAVE APPLICATION FORM

Employee Details

Field	Details
Full Name	[First Name] [Last Name]
Employee ID	[Employee ID Number]
Job Title	[Job Title]
Employment Type	[ ] Full Time    [ ] Part Time    [ ] Casual
Department/Team	[Department Name]
Date of Application	[DD/MM/YYYY]

Leave Details

Field	Details
Type of Leave	[ ] Annual Leave    [ ] Personal/Carers Leave    [ ] Long Service Leave    [ ] Unpaid Leave    [ ] Other: [Specify]
Start Date	[DD/MM/YYYY]
End Date	[DD/MM/YYYY]
Return to Work Date	[DD/MM/YYYY]
Total Hours/Days Requested	[Number]
Reason for Leave	[Provide brief reason, especially for personal/carers leave]

Supporting Documents

If applicable (e.g. medical certificate, jury duty notice)

[ ] Yes, attached    [ ] Not applicable

Public Holidays

Do any public holidays fall within this leave period?

[ ] Yes    [ ] No

Declaration

I certify that the information provided is true and correct. I understand that I must follow company policy regarding notice periods for leave.

Employee Signature: __________________________

Date: __________________________

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Employer / Supervisor Section

Field	Details
Leave Balance at Start Date	[Annual]: [Days]    [Personal]: [Days]
Leave Balance after Approval	[Annual]: [Days]    [Personal]: [Days]
Decision	[ ] Approved    [ ] Declined    [ ] Approved with Conditions
Supervisor Name	[Print Name]
Signature	__________________________
Date	__________________________

Comments / Conditions of Approval

[Add any notes regarding coverage or handover responsibilities]