Circulars 20/2008 and 13/2010
APPLICATION FOR PARENTAL LEAVE
1. Name ______________________________________________________________
2. Home Address _______________________________________________________
________________________________________________________
2.(a) Date of birth of your child _____________________________________________
(Please note parental leave is to be taken before child reaches the age of thirteen.)
(b) Please attach relevant birth cert/adoption order of the child.
4. Reason for applying for leave __________________________________________
____________________________________________________________________
____________________________________________________________________
5. Duration of leave being sought
From: __________________ To: ______________________
Total: ___________________ weeks/days/3.5 hours (delete if not appropriate)
6. Leave previously taken ___________
Has a previous application been made in relation to this circular? Yes/No
Signature
Grade
Division
Date
----------------------------------------------------------------------------------------------------------------
For the relevant Division . For Internal Personnel
.
The application is approved/not approved .
.
.
_____________________________ . _____________________________
Signature of Principal Officer . Signature for Head of Department
Date . Date