Application for pupil leave of absence in exceptional circumstances during term time.
PN 6

APPLICATION FOR PUPIL LEAVE OF ABSENCE IN EXCEPTIONAL CIRCUMSTANCES DURING TERM TIME

This form should be completed by the parent/carer and returned to the school as far in advance as possible and preferably at least 6 weeks before the first date of the period of leave being requested. Parents/carers must obtain the schools permission before making any arrangements for leave in exceptional circumstances, otherwise the absence will be recorded as unauthorised.

No parent/carer can demand leave of absence as of right. The Education regulations state that applications for leave must be made in advance by a parent with whom the child lives and can only be authorised by the school in exceptional circumstances. Each application is considered individually by the school.
The following are examples of the criteria for leave of absence, which may be considered as ‘exceptional’:

• Service personnel returning from active deployment
• Where inflexibility of the parents’ leave or working arrangement is part of the organisational or company policy. This would need to be evidenced by the production or confirmation from the organisation/company
• Where leave is recommended as part of a parents’ or child’s rehabilitation from medical or emotional problems. Evidence must be provided
• When a family needs to spend time together to support each other during or after a crisis

Please note: Head teachers would not be expected to class any term time holiday as exceptional

This is not an exhaustive list and Head teachers must consider the individual circumstances of each case when making a decision on this matter. Where a Head teacher feels that there may be exceptional circumstances which do not fit the criteria, they may refer to the local authority for advice. The decision of the Head teacher is final. Parents who take a child on leave in term time without the permission of the school risk being issued with a penalty notice fine for unauthorised absences.

Taking a pupil on leave during term time interrupts teaching and learning and can disrupt educational progress. Before completing this application form parent/carers are asked to consider the effect on their child’s continuity of education
Name of Pupil(s) *
Your answer
Date of Birth *
Your answer
Full Name of Parent / Carer *
Your answer
School *
Your answer
Class(es)
Your answer
Home address *
Your answer
Telephone Number *
Your answer
Siblings if different school *
Your answer
Sibling school attending *
Your answer
I request permission for my child to be absent from school from and to the following dates: *
Your answer
Total school dates absent
Your answer
I offer these exceptional circumstances for consideration:
My request does not fall into any of the above categories but I offer this as the reason for wanting to take my child out of school:
Your answer
Signature of parent / carer *
Your answer
Date *
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DD
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YYYY
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