RECORDS MANAGEMENT UNIT

Third Floor, West Block Building,

City of Belmopan, Belize.
+501 822-2380/2698

LONG LEAVE FORM

(11+ Days)

Name:

Post:

Section/Station:

Salary:

Date of First Appointment: day/month/year Period of Service: Years Months

Period of Service in Current Ministry:

Employment Status: Permanent Established Contract Open Vote

Leave Already Granted For Year:

Leave Now Applying For:

From: day/month/year To: day/month/year

Other Leave No. of Days From: day/month/year To: day/month/year

On Full Pay On Half Pay Leave Without Pay Maternity Leave

Contact No. Address:

Signature: Date: 02/09/2022

day/month/year

FOR OFFICIAL USE ONLY

Recommended By: Date: day/month/year

Immediate Supervisor/District Manager/Principal

Recommended By: Date: day/month/year

Chairman, Board of Management (if applicable)

Leave Entitlement: Verified By:

Date: day/month/year

Administrative Assistant/Secretary/Bursar

Approved: Date: day/month/year

Chief Executive Officer/Administrative Officer

Resumption Date: day/month/year Balance:

Remarks: