Child's Name ..............................................................................................

Class ........................................................................................................

First day of absence ......................day ........................ month ...............year

Return to school ......................day ........................ month ...............year

Number of days absent .........................

Reasons for the request, stating why holiday has to be taken in term time:

N.B. All children lose ground following absence from school. Children in Year 2 and Year 6 take national tests each year in May.


ACKNOWLEDGEMENT OF REPLY FOR HOLIDAY ABSENCE


Authorised / Not Authorised

Reasons (If not authorised) ......................................................................................

.........................................................................................................................................

Signed .................................................................. (Headteacher)

Date ..................................................................