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Oldway Primary School Absence Request Form
Please fill out this form if you wish to request an authorised absence for your child during term time. Please ensure you read the document linked in the last question of this form and agree to the information in the document.
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* Indicates required question
Date Absent From
*
Please indicate when the first day of the requested absence will be
MM
/
DD
/
YYYY
Date Absent To
*
Please indicate when the last day of the requested absence will be
MM
/
DD
/
YYYY
Child(ren)'s name(s)
*
Your answer
Child(ren)'s Class(es)/Year(s)
*
Your answer
Do you have a child who attends a different school that will also be absent?
*
Yes
No
If yes to the previous question, please give child(ren)'s name and school(s) below
Your answer
If the children will not be with you, but with another parent carer during the absence please provide their details below
Other parent/carer's name
Your answer
Other parent/carer's address
Your answer
Relationship to child
Your answer
Please fully explain the exceptional circumstances that you would like the school to consider.
*
This section must be completed. If there is any supporting documentation you would like the school to consider please attach this in the next question
Your answer
Do you have any supporting documentation?
*
If you have any supporting documentation you would like the school to consider in relation to this request, please email this separately to
oldwayoffice@rivieraet.co.uk
Yes
No
Name of person completing this request
*
Your answer
Address of person completing this request
*
Your answer
Email address of person completing this request
*
Your answer
I confirm I have read and understand the document above in relation to this request
*
Yes
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