Paternity Leave
Application Form
REF: HR 7, Rev. 1
Employee Details
Personnel Number
First name:
Surname
Unit/School
Grade
Contact No.:
Mother’s Details:

First name:
As father of the above mentioned child, I wish to
apply for Paternity Leave to be taken on the
following dates:
Surname:
Child’s Details:
First name:
Surname:
Date of Birth:
“I HAVE READ AND ACCEPT THE TERMS AND CONDITIONS OF THE PATERNITY LEAVE POLICY”
Signed:
Date:
Employee
Signed:
Date:
Head of Unit/School
Approved by:
Date:
Equality Manager