Emergency Staff Absence - Non Sickness (ESANS) Form
Full Name
*
Designation / Year Group
*
Staff Email
*
example@example.com
Start date of Absence
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
End date of Absence
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Total number of absences?
e.g. 1 day, 2 days, morning session only, evening session only etc
Is it a full day(s) absence?
*
Yes
No - Choose your leaving and returning time
What time would you like to leave the school?
*
What time would you return to the school? If you are not returning for the rest of the day, please state your normal finish time
*
Reason of Absence
*
Upload the relevant document
Please ensure that any relevant documentation is attached. Phone picture is accepted
Do you have the relevant evidence i.e. appt letter, email, text etc?
*
Yes - Upload your document below
No - Complete the following section
If No, please state the reason why you can not provide any evidence?
*
Upload your evidence here.
*
Browse Files
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Cancel
of
Staff Signature
*
Date
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
OFFICE USE ONLY
SBM Section - Attendance Review
Attendance Record
Rows
Attendance % in last 12 months
Absence (in days) in last 12 months
Episodes in the last 12 months
Total family leave in the last 12 months (if applicable)
Description
Attendance Record File
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Cancel
of
SBM Section - Attendance Review
Authorising Signature
Authorising Signature
Date
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Print Name
Please select
Approved
Declined
Cancelled
If approved, choose the option
Paid
Unpaid
Partially Paid / Unpaid
Other Notes for the Staff
Authorising Signature
Submit
Should be Empty: