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Holiday/Leave/Appointment Request Form

Where evidence is required please forward any documents to or hand it to Mrs Hanley or Miss Stone in the office.

Pupils learn new things at school every day. Missing school simply puts them behind and can hinder their chances. Please consider these implications carefully before taking your child out of school during term time.

“Head Teachers cannot grant leave of absence unless there are exceptional circumstances. The application must be made in advance and the head teacher must be satisfied that there are exceptional circumstances based on the individual facts and circumstances of the case which warrant the leave. Where a leave of absence is granted, the head teacher will determine the number of days a pupil can be away from school. A leave of absence is granted entirely at the head teacher’s discretion.” School attendance - Departmental advice for maintained schools, academies, independent schools and local authorities (Department for Education October 2014)

As you can see, Head Teacher must be satisfied that there are exceptional circumstances based on the individual facts and circumstances. “Exceptional” – rare, significant and short. If an event can reasonably be scheduled outside of term time then it cannot be authorised.

Please note, the application must be submitted no less than 10 school days before the proposed absence.

Please outline below the exceptional reasons for your application for leave or holiday.

A response will ONLY be sent back if leave is NOT approved OR it relates to a HOLIDAY / WEDDING OR AN EXCEPTIONAL CIRCUMSTANCE request. The Head Teacher will respond to these request within 4 working days.

Leave for Doctors/Hospital/Dental appointments are automatically approved for the time of the appointment and travel time only and children should come in before or after their appointment. Leave outside of this time will NOT be authorised.

Is this a full day or part day request?*
Reason for taking time off during term time:*
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