This form must be signed by a representative from , failure to do so could result in non-payment of holiday pay. You must complete and sign this form, giving advance notice which should be at least twice as long as the amount of holiday you wish to take.

Signed by  on the 

If you are paid directly by the Agency:

Please refer to your agency workers handbook for details of how holiday is accrued along with all other holiday information. You can contact your agency who can advise you of your accrued holiday rights on request.

The holiday year commences on the Company’s Financial Year week 1 and concludes on Week 52 each year (week numbers are displayed on your payslip).

If you are not paid directly by the Agency:

Please refer to your contract with your employer for confirmation of your specific holiday year. We will pass your holiday request to your employer on your behalf.

If you need advice on the specific holiday year appropriate to you please speak to your consultant/employer or refer to your contract or handbook.

OFFICE USE ONLY:

Authorised by:             ___________________________________________

Signed:                         ___________________________________________

Date:                             ___________________________________________