Calvary Leave Form Calvary Leave Form Employee Name Employee NumberStart Date (inclusive) DD slash MM slash YYYY Start Time End Date (inclusive) DD slash MM slash YYYY End Time Total Leave Days or Hours Leave Type(Required) Annual Study/TESL Personal with Certificate Personal without Certificate Long Service Full Time Service Long Service Part Time Service Compassionate Purchased Maternity Bonding Leave Without Pay Other Rate of Pay(Required) Full Pay Half Pay Double Pay (LSL only) Unpaid Compassionate Leave Relation Other Leave Details SignatureSignature Date DD slash MM slash YYYY Send a Copy of Request Form to: Calvary Anaesthetic Dept Email Lee-Ann Harris Calvary Email Graeme Gibson Calvary Email Submitted Email (will receive a copy)(Required) HiddenSenders Email Email HiddenCalvary Email HiddenLee-Ann HiddenGraeme Δ