I am the parent/carer with whom the pupil normally resides. The information I have given on this form is correct. SIGNED:..............................................................................(PARENT/CARER) DATED:…………………………………………………………………………….. School Office use only. (Tick as appropriate) Date application received: Approval granted: Yes/No A personal discussion with you is requested. Please contact:______________________________ PLEASE NOTE: This leave of absence form serves as a Penalty Notice Warning letter to parent/carers. Any unauthorised absence during this period of time may be subject to a penalty notice for non-attendance being issued. Education (Pupil Registration) (England) Regulations 2006 have been amended (as of 1 September 2013) to prohibit the proprietor (headteacher) of a maintained school granting leave of absence to a pupil except where an application has been made in advance and the proprietor considers that there are exceptional circumstances relating to the application. Headteacher (or designated authorised school signatory):_______________________________ Date: ____________________________________ Current Attendance rate:_____________________ Parent/Carer informed (* delete as required): text/ letter/ telephone call/email Date: Copy to Head of Year: Yes / No
I am the parent/carer with whom the pupil normally resides. The information I have given on this form is correct. SIGNED:..............................................................................(PARENT/CARER) DATED:…………………………………………………………………………….. School Office use only. (Tick as appropriate) Date application received: Approval granted: Yes/No A personal discussion with you is requested. Please contact:______________________________ PLEASE NOTE: This leave of absence form serves as a Penalty Notice Warning letter to parent/carers. Any unauthorised absence during this period of time may be subject to a penalty notice for non-attendance being issued. Education (Pupil Registration) (England) Regulations 2006 have been amended (as of 1 September 2013) to prohibit the proprietor (headteacher) of a maintained school granting leave of absence to a pupil except where an application has been made in advance and the proprietor considers that there are exceptional circumstances relating to the application. Headteacher (or designated authorised school signatory):_______________________________ Date: ____________________________________ Current Attendance rate:_____________________ Parent/Carer informed (* delete as required): text/ letter/ telephone call/email Date: Copy to Head of Year: Yes / No
7C6470ED7BA9FAB162A5D20F7A7835A2.docx