| Name | |
|---|---|
| Employee number | |
| Department |
Type of leave: ☐ Annual ☐ Sick ☐ Maternity ☐ Paternity ☐ Compassionate ☐ Study ☐ Unpaid
| First day of leave | |
|---|---|
| Last day of leave | |
| Number of working days | |
| Date of return | |
| Contact while away | |
| Duties handed over to |
Sick leave of more than 3 days needs a medical certificate. Maternity leave needs a medical certificate of the expected date of delivery.