Exceptional Leave Request Form
Ashford Park Primary School
Application for leave of absence for exceptional circumstances
Please read the following guidance carefully.

As parents, you have a legal responsibility to ensure your child’s attendance at school. During the academic year, pupils are at school for 190 days and at home for 175 days.

Please be aware that The Education (Pupil Registration) (England) (Amendment) Regulations 2013, which became law on 1st September 2013 state that Head teachers may not grant any leave of absence during term time unless there are exceptional circumstances. The Head teacher is also required to determine the number of school days a child can be away from school if leave is granted.

Please complete and submit this form if you want the Head teacher to consider your request for your child’s leave of absence for exceptional circumstances. We may ask for proof to back up your request.

Unauthorised absence of 5 days or more may result in the issue of a Penalty Notice.
Penalty Notices are issued by the Local Authority in accordance with Surrey County Council’s Code of Conduct. The Penalty Notice is £60, per child per parent/carer, if paid within 21 days or £120 if paid after 21 days but within 28 days. Failure to pay the Penalty Notice will result in you being served a summons to appear at the Magistrates Court.

The Headteacher will consider the reasons for the request carefully and will notify you of the decision.
For further information, please refer to our School Attendance Policy.
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Email *
Child/children's full name/s: *
Please list all children that attend Ashford park on one form.
Child/children's class:
*
Date leave is requested from: *
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YYYY
Date your child/children will return to school: *
MM
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DD
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YYYY
Number of school days they will be absent for: *
The exceptional circumstances for which leave is requested: *
Please put as much information as you can.
Has your child/children already had a leave of absence this school year? *
Please do not include any time off for illness.
Name of parent/carer completing this request: *
A copy of your responses will be emailed to the address you provided.
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