Retail Staff Maternity Leave of Absence Form
Please complete this form to request maternity leave. Your information will help us process your leave of absence efficiently.
Employee Full Name
*
First Name
Last Name
Employee ID Number
*
Job Title / Position
*
Store Location / Department
*
Contact Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Expected Start Date of Maternity Leave
*
-
Month
-
Day
Year
Date
Expected Return Date to Work
*
-
Month
-
Day
Year
Date
Emergency Contact Name and Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor / Manager Name
*
Supervisor / Manager Email
*
example@example.com
Briefly describe your handover or coverage plan during your absence
Submit Leave Request
Should be Empty: