Examination Leave
Application Form – HR 108 (e)
This form is to be used by employees to apply for Examination Leave. You must give a minimum
of four weeks notice to your employer before commencing Examination Leave. Please complete
in Block Capital/Tick appropriate boxes. Format Date fields as DDMMYYYY
To be completed by the employee
Surname: First Name:
Grade: Personnel No:
Location: PPS. No.
I hereby notify my employer that I intend to take Examination Leave in accordance with the provisions of the HSE
Terms and Conditions of Employment (Revised) May 2009
Number of days leave applied for:
From date
To date
To be completed by the Line Manager
I have checked the relevant supporting documentation required for the leave requested and confirm that the leave
required complies with the terms outlined in the relavant HR policy
Application Approved Yes No
If no, give
Signature: Date
Name (Capitals) Grade
Contact Phone No: Mobile No:
Email Address:
To be completed by Human Resources Personnel Administration
System Updated by: Name:
Contact Phone No: Date
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HR 1
08 (e)_V2 Apr 2010 Page 1 of 2 Revised 01/04/2010
Appendix 1
Explanatory Note on Examination Leave
HR 108 (e)_V2 Apr 2010 Page 2 of 2 Revised 01/04/2010
Paid study leave may be allowed to employees in respect of third level course
examinations, subject to the directions regarding the grant of leave generally and
provided the costs can be accommodated within your approved financial
(a) Employees pursuing, in their own time, primary degree courses may be
allowed ten days study leave with pay for entire period of course.
(b) Employees should be given as much freedom as possible as regards
spreading the leave over the various course examinations subject to the
condition that a maximum limit of five
days study leave with pay will apply to each
academic year.
(c) The arrangement at (a) and (b) will also apply to other third-level courses of
education which last for three years or longer. For shorter third-level courses,
three days study leave with pay may be allowed for each year of the course,
repeat years being excluded.
(d) Employees pursuing the following courses will be recognised as eligible or
study leave:
(i) University course leading to the degrees of Bachelor or Masters of Arts or
(ii) The course leading to the Diploma in Administrative Science and the one –
year course in Public Administration provided by the Institute of Public
(iii) Courses in the following subjects
Accountancy, Business Administration, Business Studies, Computer Science,
Economics, General Management, Hospital Administration, Industrial
Engineering (for Engineers), Law (for BCL, BL, or Diploma in European Law
Personnel Management, Public Administration, Secretaryship (Institute of
Chartered Secretaries), Sociology, Statistics, Systems Analysis
c.f. DoHC Circular No. 146/72
NCHDs are entitled to a total of two weeks leave per six months prior to an
examination or repeat examination for approved higher degrees or diplomas. The
Hospital r
equires evidence both prior to and subsequent to sitting of the
examinations in certain circumstances where the NCHD can demonstrate a
benefit to the Health Service to his /her clinical supervisor and the appropriate
hospital manager, other courses will be considered on an individual basis
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