This form should be used by a public service employee when applying to convert to an additional leave arrangement. The information collected on this form is required for pay and leave entitlements. Information regarding additional leave is available at: . Privacy: The information collected on this form is for the purpose set out and is required to process your request. Your information will not be disclosed without your consent or unless authorised or required by law. You are able to request access to the personal information that the Department holds about you and request that it be corrected by contacting your Principal/Manager. Information about contacting the People Division is available at: Information about the Department’s privacy policy is available at: . Employee Details Family Name Given Name(s) Employee ID Work Unit Name Region/Division Application I wish to convert to a / 52 additional leave arrangement from: ..…/…../….. to: .…./…../.…. (where end date applies) Employee’s Signature: Date: / / APPROVAL Manager’s Name: (Please Print) Manager’s Signature: Date: / / Please forward completed form to Corporate People Services. OFFICE USE ONLY-WHERE REQUEST IS APPROVED eduPay updated by Date ___/___/_____ The completed form is to be placed on the employee’s personnel file.
This form should be used by a public service employee when applying to convert to an additional leave arrangement. The information collected on this form is required for pay and leave entitlements. Information regarding additional leave is available at: . Privacy: The information collected on this form is for the purpose set out and is required to process your request. Your information will not be disclosed without your consent or unless authorised or required by law. You are able to request access to the personal information that the Department holds about you and request that it be corrected by contacting your Principal/Manager. Information about contacting the People Division is available at: Information about the Department’s privacy policy is available at: . Employee Details Family Name Given Name(s) Employee ID Work Unit Name Region/Division Application I wish to convert to a / 52 additional leave arrangement from: ..…/…../….. to: .…./…../.…. (where end date applies) Employee’s Signature: Date: / / APPROVAL Manager’s Name: (Please Print) Manager’s Signature: Date: / / Please forward completed form to Corporate People Services. OFFICE USE ONLY-WHERE REQUEST IS APPROVED eduPay updated by Date ___/___/_____ The completed form is to be placed on the employee’s personnel file.