Request For A Career Break Form
Please read the Career Break Policy when completing this form and send it by email to your line manager who will consider and respond to your request. This must be received 3 months in advance of the Career Break Period.
Colleague Name:
Job Title:
Store / Function: Date of Request:
Manager Name: Your email address:
Confirmation of Request
I’m making a formal application for a Career Break
Have You Made Any Previous Applications For A Career Break?
Yes / No
Details of Previous Applications:
I confirm that I have read the Career Break Policy and understand that any benefits I am currently in receipt of will be suspended for the duration of any agreed Career Break.
Colleague Signature Date