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Exceptional Absence Request Form

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Exceptional Absence Request 

Schools are unable to grant any leave of absence during term time, unless there are 'exceptional circumstances'.  In such cases, parents must complete the form below, which requires authorisation from the Headteacher.  The Headteacher may request evidence of the circumstances for which leave of absence is being sought.

*
Question 1.

Name of Child

- Required.
*
Question 2.

Class

- Required.
*
Question 3.

First date of absence

- Required.
*
Question 4.

Reason for planned absence

- Required.
*
Question 5.

Return to school date

- Required.
*
Question 6.

Number of days missed

- Required.
*

If a child fails to return after their leave of absence, the child’s place may be given to another child unless agreed beforehand with the Headteacher.

Signed and dated by Parent:

- Required.

For School use only:

Current Level of absence:
This is required