Employee Leave Request Form

Home/Employee Leave Request Form

Please fill out this form to apply for / notify us of your absence.

First Name(Required)

Last Name(Required)

Email(Required)

Contact Number(Required)

First Day of Leave(Required)

Last Day of Leave(Required)

Date Returning to Work(Required)

Number of Days Off(Required)

Type of Leave(Required)

Reason for Requested Leave

Upload Medical Certificate

Max. file size: 2 MB.

Upload Medical Certificate

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Name

This field is for validation purposes and should be left unchanged.

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