Leave Application Form — Kenya

How to use: Replace every [bracketed field] with your details and delete guidance notes in italics. This is a general template aligned with Kenyan practice — for high-stakes matters, have it reviewed. Need it done for you? Talk to Virtual Ivy.

Employee name	[Name]	Staff no.	[No.]
Department	[Dept]	Date of request	[Date]

Leave details

Type	☐ Annual ☐ Sick ☐ Maternity ☐ Paternity ☐ Compassionate ☐ Unpaid ☐ Other: [__]
From	[Date]
To	[Date]
Number of days	[__]
Handover / cover	[Who covers duties]
Contact while away	[Phone/email]

Approvals

	Name	Signature	Date
Employee
Line manager
HR

Leave balance before: [__] · after: [__]