Please submit your holiday request below Submit Holiday Request Full Name(Required)Date of Birth(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Contact Number(Required)Select a Branch Keighley Branch Burnley Branch This form is only a request for holiday to be taken - it does not automatically grant a holiday.You are entitled to 28 days holiday in any 12 month period. Your holiday is accrued on a 12 month rolling year based on hours worked. It is a requirement that ALL requested holiday pay is received by the agency in writing at least one week prior to the first day of holiday to be taken. Should a request be received later than one week then this may result in payment being made after the dates requested. The holiday period is from 1st Jan – 31st Dec.Accept Terms(Required) I have read the above statement Employer(Required)DepartmentSupervisorFirst Day of Holiday MM slash DD slash YYYY Last Day of Holiday MM slash DD slash YYYY Total Days Claiming For(Required)CAPTCHA Δ
