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 POSITION:

ADDRESS / CONTACT NO:
 ATTACHMENT:
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EMPLOYMENT STATUS:
 REGULAR
 PROBATIONARY
 TRAINEE
 OTHER(S) 		PAY:
 W/PAY  WITHOUT PAY
TYPE OF LEAVE:
 VACATION
 SICK
 OTHERS:
DATE APPLIED:
FROM:
 
TO:
 
HALFDAY:
UNDERTIME:
TOTAL DAY(S):
REASON(S) FOR LEAVE:
DATE:
 
APPROVAL(S) SIGNATURE:
SUPERVISOR:
DATE:
HR DEPT:
DATE:
ADMIN/FINANCE DEPT:
DATE: