IMPORTANT: A receipt of this form along with all details entered will be sent to the email address provided on this page.
As a parent or carer you should fill in this form if you want to take your child out of school during term time to go on/to a medical appointment, holiday or family emergency that requires time away from school.
In the case of a family emergency please also e-mail the Headteacher, via the email address firstname.lastname@example.org
, as well as completing the form.
Please complete the form no less than 10 days before the date when you want the period of absence to start.
IF THE ABSENCE IS IN LESS THAN 5 WORKING DAYS DO NOT COMPLETE THIS FORM - PLEASE JUST EMAIL THE FOLLOWING ADDRESS WITH ALL THE DETAILS: email@example.com