LEAVE REQUEST FORM "*" indicates required fields Name* First Last Your Email Address* Phone number*Reason for leave*Reason for leavePersonal Sick LeavePersonal Carers LeaveCompassionate LeaveLong Service LeaveParental LeaveOther Leave – please specifyTotal number of leave days off:Date of first day of leave:* Date of last day of leave:* Return to work date:* Comments:Declaration I, agree that the above information is true and correct.SignatureDate*
