MINISTRY OF LABOUR AND SMALL ENTERPRISE DEVELOPMENT

ON-THE-JOB TRAINING PROGRAMME

Corner Chaguanas Main Road and Connector Road, Chaguanas
Tel: (868) 671-4447 / 671-7822 / 671-1764 / 671-3457
Website: molsed.gov.tt
TRAINEE APPLICATION FOR LEAVE OF ABSENCE FORM

TO: ______________________________________________________
Name of Supervisor/Head of Department

NAME OF TRAINEE: __________________________________________________

TRAINING PROVIDER NAME: __________________________________________________

TRAINING ADDRESS: __________________________________________________

Indicate the ‘leave type’ being applied for, from the list below:
LEAVE TYPE START DATE END DATE
SICK (Medical Certificate for ≥ 3 days)
*DISCRETIONARY
MATERNITY (Copy of NI12 form attached and duly completed by the Medical
Practitioner and OJTP Regional Officer)
EXAM (documents attached-stamped and signed)
*BEREAVEMENT (Copy of Death Certificate indicating relation)
*NO PAY LEAVE

* Reasons: ____________________________________________________________________________

___________________________ _________________________
TRAINEE’S SIGNATURE DATE

Recommended Not Recommended

Signature and Department / Company Stamp

______________________________ ___________________ ____________________________

SUPERVISOR’S NAME DATE SUPERVISOR’S TITLE

Comments:
Approved Not Approved

_____________________________ __________________
PMO I DATE

P.S. Leave taken without prior approval from the OJT and Provider may be treated as a breach of contract. All approved leave applications
must be submitted with your monthly timesheets.

OJT Head Office: Corner Chaguanas Main Road and Connector Road, Chaguanas Tel: 671-7108; Chaguanas Office: Corner John & Lange Streets Montrose, Chaguanas Tel:665-6658
Point Fortin Office: 69 Main Road, Point Fortin Tel: 648-5810; Port of Spain Office: Levels 5 & 6, Tower C, IWC, Wrightson Road, Port of Spain Tel: 625-8478
San Fernando Office: 40-42 St James Street, San Fernando Tel: 652-1350, 652-3181
Siparia Office: Siparia Administrative Complex, Corner Allis Street and SS Erin Road, Siparia Tel: 649-0982
Tunapuna Office: Anva Plaza, 16-20 Eastern Main Road, Tunapuna Tel: 645-8261; Tobago Office: Lot #2 Glen Road, Scarborough Tobago Tel: 685-8187