School Date Area Date Region Date Head Office Date
Received on Received on Received on
Dispatched on
Dispatched on Dispatched on Dispatched on
Leave Application Form
Section A: To be filled by Employee
Employment Information:
*Employee Code: _______________ *Employee Name: ___________________________ DOJ: ______________
Designation: _________________________________ Region: ___________________ Area: ___________________
Location: __________________________________________ Department: School *School ID: ________________
*School Name: ________________
Leave Request (Leave Details):
*Leave Type: Casual Medical Hajj Maternity Iddat
Other (Please Specify): _____________________ Leave Status: With Pay Without Pay
*Number of times Maternity/Hajj Leave availed in TCF: ___________________
*Leave applied for (Days): ______ *Leave (Start Date): _______________ *Leave (End Date): _____________
Contact Information (During leave):
Contact Address (During Leave): ____________________________________________________________________
*Contact Number (During Leave): ___________________________
Availing Hospitalization Benefits: Yes No Health Insurance Card #: __________________________
Type of Medical benefits availing (specify): ________________________________________________________________
Signature of Applicant: _______________________________ Date: ____________________
Section B: For Office use only
To be filled by Principal:
Type of Leave Balance Before Leave Applied Balance After
Application Application
Casual Leave
Medical Leave
HRP-CD-08 Revised August 2018
Approval:
Principal’s Signature: __________________________________ Date: _____________________
AM’s Signature: _______________________________________ Date: _____________________
RM’s Signature: _______________________________________ Date: _____________________
*Note: Please tick attached supporting documents
Copy of Medical Certificate for Maternity Leave
Copy of Passport and Ticket for Hajj Leave
Any other supporting document (Please mention): ___________________________________________
HRP-CD-08 Revised August 2018