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Stafford Staff Application for Leave
When requesting leave during the school holidays or for extended periods, please submit this form three months in advance. For all other cases, please submit for approval at least two weeks in advance.
Date
*
MM
DD
YYYY
Type of Leave
*
Annual Leave
Sick Leave
Bereavement Leave
ACC
Study Leave
Leave Without Pay
Name
*
First
Last
Start Date
*
MM
DD
YYYY
End Date
*
MM
DD
YYYY
How much leave are you applying for?
*
Week Ending Date of Leave to be paid:
Reason for leave:
Please note: Where there is no leave available, entitlement may only be taken at the discretion of management.
Official Use Only
Your application for leave has been:
Reason for decline
Decision Date
*
MM
DD
YYYY
Please check for security purposes
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