Parkwood
Primary School

Pupil Absence Request Form

Important information For Parents/Carers

In September 2013 amendments were made to the 2006 Regulations in the Education (Pupil Registration) (England) (Amendments) Regulation 2013 which made it clear “Headteacher may not grant any leave of absence during term time unless there are exceptional circumstances.

As a result, consequences for parents taking children on holiday in term time which are not authorised by the school MAY result in a penalty Notice fine of £80 per parent per child being issued by the local authority (Hackney Education).

Please complete all fields marked (*)

Your first name *

Your last name *

Your email *

Name of Pupil *

Class/Year Group *

Date of proposed first absence *

Date of proposed last absence *

Total number of days absence requested *

Reasons For Proposed Exceptional Circumstances *

What documents/evidence will be submitted to the school office? *

Destination *