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LEAVE REQUEST FOR Mr.

Fistname Lastname
[The request must be submitted at least 15 days before the 1st day of absence]

Dates of Leave (or Teleworking):


Date of first day: AM PM
Date of last day: AM PM

Type of Request:
1. Annual Leave No. of days to be deducted from annual leave entitlement:
2. Sick leave* Medical certificate provided Yes No
3. Special leave (please specify details):
4. Teleworking outside of Bangkok

Contact mobile phone no. during leave: +668-XXXX-XXXX

Requested by: Date:

Approved by Supervisor: Date:

Verified by Admin section: Date:

Approval by Head of Regional Office: Date:

Carried-over from last year 0.0


Entitled leave this year 24.0 * Sick leave is to be signed by requestor and Admin section only.
Total for 2023 24.0

Annual Leave (AL) No. of Balance Sick Special Comments


AL of AL Leave Leave

TOTAL 0.0 24.0 0.0

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