Leave of Absence request form
Please read the information below before completing this form:

1. The decision to grant the request is for the school, not the Authority or the parent. Only school can authorise absences.
2. There is no requirement to authorise just because a request has been made.
3. The Anti-Social Behaviour Act (2003) gives the Local Authority the power to issue fixed penalty notices for unauthorised leave of absence during term time.
4. No parent can demand leave of absence for the purpose of a holiday as a right.
5. Any request for leave must be made in advance.
6. Holidays cannot be authorised retrospectively.
7. If the application for leave of absence in term time is made because of the parent's workplace holiday arrangements then a letter from the employer explaining why the leave of absence must be taken in term time must be provided on proper letter-headed paper.
8. If important work has been missed by the pupil due to the parents making a request for leave of absence for a holiday the parents should not expect special arrangements to be made by the school for the pupil to catch up that work.
9. The circumstances of each individual request will be taken into account. The following factors may be relevant but this should not be regarded as a comprehensive list:
- Parent's workplace holiday arrangements if supported by a letter from employer.
- The overall attendance of the child for the previous academic year or 3 terms.
- If taking leave of absence in the first half of the first term would have a negative impact on pupil progress.
- If a previous holiday has been taken in the same academic year.
- Timing of internal and/or external examinations/assessments.
- The reason given by a parent for requesting leave of absence in term time.

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Full name of child(ren) *
Class/Year group of child(ren) *
Leave of absence start date *
MM
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DD
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YYYY
Leave of absence end date *
MM
/
DD
/
YYYY
Number of school days missed *
Reason for requesting Leave of Absence at this time *
A LETTER FROM AN EMPLOYER MUST BE PROVIDED IF THE ABSENCE IS DUE TO WORK COMMITMENTS.
Parent name 1 *
Date of birth *
MM
/
DD
/
YYYY
Address *
Postcode *
Parent name 2
Date of Birth
MM
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DD
/
YYYY
Address
Postcode
Date of application *
Children at other schools:
Name of child
School
If you go ahead with the leave of absence when unathorised, you may receive a FIXED PENALTY NOTICE issued through the Local Authority. This will be £60 per parent per child if paid within 21 days rising to £120 per parent per child if paid within 28 days.
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