Leave of absence form
Hodge Clough Primary School leave of absence notification form
*This form should not be used for illnesses or medical appointments*
Please note that unauthorised absences of 5 school days and over can incur a Fixed Penalty Notice of £60 per parent per child. If you feel that there are exceptional circumstances and that this absence should be authorised please outline this below, this does not guarantee authorisation and we will look at on a case by case basis.
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What is your child's name? *
Name of the parent or guardian filling in this form. *
What year group is your child currently in? *
Required
What dates will your child be absent from school from? *
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What date will your child return to school? *
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Which country will your child be in during this period of absence?
Do you feel there are exceptional circumstances in relation to your child's absence in which consideration should be given for authorisation?
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If you answered yes please explain why you feel your child meets the requirements of exceptional circumstances.  Please note, that family holidays are not deemed exceptional circumstances.  
Thank you for filling in this form. Please press the submit button and your form will be sent directly to the school.
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