Absence Request Form 2021-22

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Pupils should not be taken out of school during term-time, so as not to interrupt their learning and impact on their education. Any absence requests, other than for medical/senior school appointments, will be marked as unauthorised for registration purposes unless the Head considers them to be for extenuating circumstances. Please support your child by not arranging holidays during term-time and, where possible, arranging any appointments, ie medical, outside of school hours. Thank you.

Email *

Pupil First Name *

Pupil Surname *

Pupil Form *

First Date of Requested Absence *

YYYY

Last Date of Requested Absence *

YYYY

Number of Days if full school days

If not full days, please mark as below

Part day (less than a full or half-day)

Half day

Clear selection

If not a full day, please mark below the requested sign-out time

Time

If not a full day, please mark below the estimated return time (if applicable)

Time

Reason for Absence *

Medical Appointment (please liaise with the School Nurse as necessary)

Senior School Visit/Assessment

Holiday

Other

For Medical Appointments - please complete reason for medical appointment ie, routine GP, orthodontist etc

For Senior School Visits/Assessments, please complete the name of the Senior School

For Holiday, please complete reason and other supporting information for term-time request

For Other, please complete details

Please complete Parent/Guardian Name

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Hazelwood School. Report Abuse

Forms