CORDILLERA QUEST: CORDILLERA QUEST:

Center for Complementary Education & Social Work Services Center for Complementary Education & Social Work Services

APPLICATION FOR LEAVE/UNDERTIME APPLICATION FOR LEAVE/UNDERTIME

Date: __________________________________ Date: ________________________________________

Name: _________________________________ Name: _______________________________________
Position: _______________________________ Position: _____________________________________
Applies for: ______day/s leave under time: -----------hrs. /min. Applies for: _________ /day/s leave under time ____hrs. /min
Starting on: ____________ Up to: _________________
Starting on: _________________ Up to: ______________________
Reasons:
[ ] Unpaid leave [ ] UNDERTIME
Reasons:
Request to be made 8 weeks before desired date
[ ] Unpaid leave [ ] UNDERTIME
Reason: [ ] Vacation [ ] Personal
Reason : [ ] Vacation [ ] Personal
Request to be made 8 weeks before desired date
[ ] Emergency
[ ] Emergency
[ ] Sick Leave - Must submit Medical Certificate if leave is 3 days
[ ] Sick Leave - Must submit Medical Certificate if leave is 3 days
[ ] Maternity / Paternity Leave –must submit birth certificate of the
child
[ ] Maternity / Paternity Leave- must submit birth certificate of the child
[ ] as Paid leave :
[ ] as Paid Leave:
Reason:_________________________________________
Reason:______________________________________________
Employees Signature:
Employees Signature:
___________________ ____________________
____________________________________________________________________
For Administration use only
For Administration use only
Number of Days approved :
Number of Days approved : From: ____________________ To: _____________________________
From: ____________________ To: _____________________________
Resumption of Duties on : _________________
Resumption of Duties on : _________________

Endorsed by: Approved by: Date: Endorsed by: Approved by: Date;

____________________ _______________ __________ _____________________ ____ _______________ -__-_-__-___--

Executive Director Executive Director