Long Term Absence Request
(For student's absences more than 3 days)
Student Name
*
Preferred Name
Surname
Year Group
*
Please Select
07
08
09
10
11
12
13
Tutor Group
*
Please Select
B1
B2
C1
C2
K1
K2
M1
M2
N1
N2
S1
S2
Requested School Leave Dates
Nature of Request of Absence
*
Sporting Event
Family Leave
Medical Leave
Performance Leave
Interview Leave
Other
Details of Explanation
*
Start Date
*
-
Day
-
Month
Year
Return to School Date
*
-
Day
-
Month
Year
First day back at school
Time duration of absence
Supporting document (e.g. Release letter, Flight detail, Medical Certificate)
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Parent Name
*
Parent Email
*
example@example.com
Signature
Please complete the following field to avoid duplicate submissions.
*
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