Holiday Request Form

We ask that you complete this form to request term time leave for your child. Requests will be considered on a individual basis and a decision will be made as to whether the leave will be authorised or not authorised. Holidays will only be authorised if your child’s attendance is above 94% and the school feel that there are special circumstances that warrant this leave. The timing of the holiday will also be taken into account. 

Please note that any time taken off in term time can have an adverse effect on your child’s progress. Regular and excellent attendance is rewarded.


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Email *
Name of child:
Class:
Date from:
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DD
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YYYY
Date to: 
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/
DD
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YYYY
Total number of days requested:
Reason for request:
Destination of holiday:
Signed: 
Date of completion:
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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