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HR6 fields

Leave Request

Let employees request time off.

Spam protectionEmail notificationsAI sales agentSubmission dashboardNo backend needed

Live Preview

Exactly what visitors will see on your site

Leave Request

What you'll collect

Every field in this template, ready to use out of the box.

Employee Name

text · required

Work Email

email · required

Leave Type

select · required

Start Date

date · required

End Date

date · required

Reason

textarea · optional

Copy the Code

Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.

<form
action="https://flowqen.com/api/f/YOUR_FORM_ID"
method="POST"
class="max-w-xl mx-auto rounded-[32px] border border-white/10 bg-[#1f1a17] px-6 py-7 shadow-[0_28px_90px_rgba(23,16,12,0.28)] sm:px-8"
>
<h2 class="text-2xl font-semibold tracking-tight text-white mb-6">Leave Request</h2>
<div class="space-y-4">
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Employee Name</label>
<input type="text" name="employeeName" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="John Doe" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Work Email</label>
<input type="email" name="email" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="john@company.com" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Leave Type</label>
<select name="leaveType" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" required>
<option value="">Select...</option>
<option value="Vacation">Vacation</option>
<option value="Sick">Sick</option>
<option value="Personal">Personal</option>
<option value="Parental">Parental</option>
<option value="Unpaid">Unpaid</option>
</select>
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Start Date</label>
<input type="date" name="startDate" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">End Date</label>
<input type="date" name="endDate" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Reason</label>
<textarea name="reason" rows="4" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18 resize-none" placeholder="Brief reason..." required></textarea>
</div>
</div>
<!-- Honeypot (spam protection) -->
<div style="display:none">
<input type="text" name="_gotcha" style="display:none" />
</div>
<button type="submit" class="mt-6 w-full rounded-[20px] bg-white py-3 text-sm font-semibold text-[#201814] transition hover:bg-stone-100">
Submit
</button>
</form>

What is a Leave Request?

An employee leave request form. Staff specify leave type, dates, and coverage arrangements.

Frequently Asked Questions

Common questions about hr form templates.

Start with this Leave Request

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