New Staff Absence Known in Advance (SAKIA) Form

New Staff Absence Known in Advance (SAKIA) Form
Full Name*
Designation / Year Group*
Staff Email*
Start date of Absence*

DayMonthYear
Date
End date of Absence*

DayMonthYear
Date
Total number of absences (i.e. days, hours)*
e.g. 1 day, 2 days, half day, morning session only, afternoon session only etc
Type of Absence*

Medical / Hospital AppointmentSurgery or other long term treatmentAttending Funeral (Immediate Family)Attending Funeral (Non-Immediate Family)Attending Wedding (Immediate Family)Attending Wedding (Non-Immediate Family)Family/Emergency Leave - Care for dependentJob Interview LeaveReligious DayParent Bereavement LeaveCompassionate LeaveUnpaid / Personal LeaveAnnual LeaveJury ServiceWell being DayOther
I confirm and understand that annual leave for all year-round staff runs from 1st April to 31st March and under no circumstances Statutory Leave can be carried over from one year to the next.

I also understand that it is essential for employees to ensure they take their annual leave on time and it is the responsibility of each employee to submit their annual leave applications promptly and in accordance with the established procedures.
Is it a full day(s) absence?*

YesNo
What time would you like to leave the school?*
What time would you to return to the school? If you are not returning for the rest of the day, please state your normal finish time*
Reason of Absence*
Please state the reason of this arrangement being made in the school hours*
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?*

YesNo
Upload your evidence here. *

Cancelof
Pleas note, if you don't have any evidence, this leave may be considered unpaid leave until you provide any evidence.
If No, please state the reason why you can not provide any evidence?*
Staff Signature*

Clear
Date*

DayMonthYear
Date
OFFICE USE ONLY

SBM Section - Attendance Review
Annual Leave Record
Annual Leave Entitlement

Attendance Record

	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

Cancelof

SBM Section - Attendance Review

Authorising Signature
Authorizing Signature

Clear
Date

DayMonthYear
Date
Print Name
Please select

ApprovedDeclinedCancelledApproved - Agency Staff
If approved, choose the option below

PaidUnpaidPartially Paid / UnpaidAnnual Leave Paid
Other Notes for the Staff

Authorising Signature
Should be Empty:

New Staff Absence Known in Advance (SAKIA) Form

Upload the relevant document

Pleas note, if you don't have any evidence, this leave may be considered unpaid leave until you provide any evidence.

OFFICE USE ONLY