Request for Exceptional Leave of Absence

UPDATED September 2024

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, state that Headteachers may not grant any leave of absence during term time unless there are exceptional circumstances. The Headteacher 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 wish for the Headteacher to consider your request for your child’s leave of absence for exceptional circumstances. We may ask for proof to validate your request. 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.

Unauthorised absence of 5 days or more will result in the following action being taken:

1. If you have not incurred a penalty notice relating to this child/ these children since 19 August 2024, then the penalty notice will be charged at the rate of £160.00, per parent/carer per child, if paid within 28 days. This will be reduced to £80.00 if paid within 21 days of receipt of the notice. Failure to pay the Penalty Notice will result in Surrey County Council considering legal proceedings against you in the Magistrates Court.

2. If you have incurred a penalty notice relating to this child/ these children since 19 August 2024, the rolling 3 year period will be activated from the date of the first penalty notice and the second penalty notice will be charged at the flat rate of £160.00, per parent/carer per child, if paid within 28 days. There will be no reduction for payment within 21 days. Failure to pay the Penalty Notice will result in Surrey County Council considering legal proceedings against you in the Magistrates Court.

3. If you have incurred 2 penalty notices relating to this child/ these children in the rolling 3 year period since the first penalty notice was issued, then you will NOT receive a third penalty notice – Surrey County Council will have no option but to consider a prosecution, per parent/carer per child, in the Magistrates Court under s 444 Education Act 1996.

Child/ren Full Name:* Child/ren Class:* If the absence is for MORE than 1 day please enter the address of the parent applying for leave of absence: First day of absence (dd/mm/yyyy):* Last day of absence (dd/mm/yyyy):* If the absence is for LESS than one day, please enter the time of the absence below: Please give reasons for your decision to take your child out of school during term time, identifying particularly why this time cannot be taken during school holidays (500 characters):**

If your child usually has a school dinner please confirm if they still require one on the date of the planned absence:YesNo

Please attach any supporting documentation supporting your request here (e.g. flight/hotel booking, wedding invitation, appointment letter): No file chosen In lieu of signing a paper copy of this form I hereby confirm all information provided on this form is accurate (please type your full name as parent or carer):* Please enter your email address to receive a copy of your submitted form:*

Request for Exceptional Leave of Absence

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