JBSL

Leave Application Form

Section A: (To be completed by the staff)
Name:________________________________________________________________________________
Designation: _____________________________

Department: _____________________________

Type of Leave required? Annual / Sick /Days Off / Without Pay / Maternity / Compassionate
Leave required for _____________ days from ____________ to _______________
Address and telephone number during leave:______________________________________________________________

__________________________________________________________________________________________________
Signature of staff: _____________________

Date: ____________________________

Section B: (To be completed by the HR & A Department)

Balance before availing leave:
Annual:
Sick:
Casual:
Study:
Signature: Human Resources Manager: ___________________

Date:

Section C: (To be completed by the Head of Department)

Days Annual / Sick / Days off / Without Pay / Maternity / Compassionate / Leave recommended
Signature of Head of Department:

_______________________

Date: _________________________

Section D: (For HR & A Department use only)

Approved: _____________ Days Annual / Sick / Days off / Without Pay / Maternity / Compassionate
Leave from ______________________ to ___________________
Signature : Manager Human Resources : ____________________

Date:_________________