Exceptional Leave of Absence Request

Please note unless this form has been completed at least 4 weeks before the absence, and would have been authorised by the school, the absence will be recorded as unauthorised. Permission for any absence during term time will only be granted in EXCEPTIONAL CIRCUMSTANCES – please see our Attendance Policy, available on the school’s website. It is possible that the Local Authority could issue a Fixed Penalty Notice to parents/carers where a pupil has incurred a number of unauthorised sessions of absences. The Fixed Penalty Notice referrals are completed by the school and sent to the Education Attendance Service who will issue parents/carers with a fine. The reasons supplied on this form will be used to inform whether the absence is authorised or unauthorised. Please provide as much detail as possible.
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Email *
Child's Name
*
Child's date of birth *
MM
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DD
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Child's class  *
Required
First day of absence
*
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DD
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YYYY
Last day of absence
*
MM
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DD
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YYYY
Reason for absence - please state why you are unable to take this leave of absence during the school holidays
*
Name of person completing this request
*
Date completed *
MM
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DD
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YYYY
I understand that a form will need to be completed for each pupil I am requesting leave of absence for
*
Submit
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