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Notification of Absence

OLDBURY ON SEVERN CHURCH OF ENGLAND VC PRIMARY SCHOOL

Request for your child to be absent from school during term time

Before completing this request form, parents/carers must:

· read the additional information issued by South Gloucestershire Council Local Authority on this form.

PLEASE NOTE THE FOLLOWING:

Department for Education School Attendance – published October 2014 states – Head teachers should not 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.  Completed forms MUST be returned to the office well in advance of any proposed absence.  We advise parents and carers not to book any travel arrangement until they know the outcome of this request.

Permission is requested for the absence of:

Child’s Name: ...........................................................................................................

Class: ..................................
 

From: ....................................

To: .......................................

Total school days requested= .......................................

Inclusive, in order for him/her to:

Please give full details of the exceptional circumstances and why you require this absence during term time.

 

 

 

Please use additional paper if required.
 

If you are travelling aboard during this absence please name the country you are visiting here: .....................................................................

 

Signature of parent or carer ………………………………………………………………….

Date ………………………………….

For completion by office:

Previous attendance record is Good / Satisfactory / Poor   

                                      (100-97%)    (96-90%)    (<90%)

Percentage attendance is ………….%

The proposed dates coincide with ………………..…………………………………………………

Previous exceptional circumstances requests ……………. Days. 

Broken weeks this academic year ……….……%
 

GOVERNOR’S/HEAD TEACHER’S DECISION:

Permission for the above exceptional circumstances absence is:  Granted / Refused

The reason is given in the letter attached.

(if your child is taken out of school after being refused, it will be classed as an unauthorised absence)

 

SIGNED …………………………………………..……………… DATE ……………………
 

If the school refuses to authorise the proposed absence and you still choose to go ahead, the school may request the Education Welfare Service to consider issuing you with a Fixed Penalty Notice (fine).