LEAVE APPLICATION FORM

NAf.-tE:

DEPARTMENT:

\ TYPE DATES

FROM TO NR. OF DAYS'

Annual
Sick
Compassionate
Maternity
Sold
Exams
Other

Staff Signature: _

During my absence the following staff members will perform my functions:

Mail queue Signed _

Daily Duties . Signed _

Special Duties ______ Signed _

While I'm away I can be contacted on: _

I HUMAN RESOURCES INFORMATION

Confirmed that has __ days from _

Current Annual Leave _ Accumulated Annual leave _

SIGNATURE: DATED:

MANAG MENT APPROVAL

MANAGER'S N.~ME: DATED: _

- -.- SIGNATURE:
--t--::'-;=;-7:;::;-;-;:~- ------------------------------. '
~ -- -

(N.B.: Copy of approved signed form should be sent to MOZHRD for record.)

Human Resources Department

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