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Run: Personal Leave Application Form

A Personal Leave Application Form for employees to request time away, document dates and coverage, and confirm benefit and return-to-work preferences. Use it...

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Employee Information

Full Name (required)

Enter your legal name as it appears in company records.

Employee ID (required)

Used to match your request to your employee record.

Department (required)

Your current department or team.

Work Email (required)

We will use this to contact you about your request.

PII Notice

By submitting this form, you consent to HR using the personal information you provide to review and process your leave request, maintain an audit trail, and contact you about the request. Please do not include sensitive medical details.

Leave Request Details

Leave Type (required)

Select the type that best matches your request.

Start Date (required)

The first day you expect to be away from work.

End Date (required)

The last day you expect to be away from work.

Estimated Leave Duration (Days)

Automatically calculated from the start and end dates.

Reason Summary (required)

Provide a brief, general explanation for the leave request. Keep it concise and avoid sensitive details.

Is this leave intermittent or non-consecutive? (required)

Intermittent Schedule Details (required)

Describe the expected pattern of time away, if known.

Coverage and Work Handover

Coverage Plan

List key tasks, deadlines, or contacts that should be covered during your absence.

Handover Contact

Optional name of the colleague who will help with coverage.

Supporting Files

Upload any documents needed to support scheduling or handover planning.

Benefits and Pay Preferences

Do you want to continue benefits during leave? (required)

Benefits Preferences or Questions

Use this field to note any benefit continuation preferences or questions for HR.

Return to Work Intent

I intend to return to work after this leave period. (required)

Check this box to confirm your intent to return after the approved leave period.

Yes No N/A

Expected Return Date

If known, provide your expected return date.

Acknowledgement (required)

I confirm that the information provided is accurate to the best of my knowledge and understand that submission does not guarantee approval.

Yes No N/A

Get your results

Enter your email — we'll send you a PDF of your filled-out template. We won't sign you up to anything; you can opt in to the trial from the email if you want.

Email (required)

Your name (optional)

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