Guardian Leave Application Form

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Tel: (02) 8853 6200

DEALER AREA

EMPLOYEE DETAIL

Name *

First

Last

Position/Department *

Contact Number *

Email *

LEAVE TYPE *

Annual leave (full pay)
Personal/Carers leave
Annual leave in advance *
Leave without pay
Compassionate leave
Partial day/s leave
Maternity / paternity leave
Long service leave
Time in Lieu – Add detailed notes in comments

*Note: Upon termination of employment, leave taken that has not been accrued will be withheld from wages.

Comments

PERIOD OF LEAVE

First day of leave *

Last day of leave *

Partial Day / Hours of leave

Certificate provided

Note: A medical certificate is always required for partial day leave – a medical appointment cannot be considered leave and the time for such leave should be made up during the same pay week if possible

Total number of working days off (Do not include public holidays and non-working days in the total.) *

Return to work date *

Reporting Manager

Date of Leave Submission *

Submission *

I submit the abovementioned leave request. I understand that all leave is subject to Management approval and I will be advised when approval has been given. I undertake to follow up with Administration if I have not been advised of approval in a reasonable period.