Carr Manor Community School

Carr Manor Community School

Exceptional Circumstances Request Form

Date of request:
Name of children / First name / Surname / Year group / Date of birth
Leaving date: / Date due back in school:
Length of absence applied for (number of school days only):
Siblings in other schools: Please note this request information will be shared with the attendance lead in the school in which the sibling(s) attend / First name / Surname / School
Contact Details
Parents:
(eg. Mother, Father, Grandparent, Carer): / First name:
Surname: / First name:
Surname:
Address:
Postcode: / Address:
Postcode:
Email:
Home phone number:
Mobile:
Alternative number while absent: / Email:
Home phone number:
Mobile:
Alternative number while absent:
Reason for absence including full explanation (use a separate sheet of paper if necessary)
The exceptional circumstances are….
Point of departure (eg. Airport, coach, train station etc): / Destination:
Address:
Contact telephone number:
Date and time of departure: / Flight numbers and name of airline:
Date and time of return: / Flight numbers and name of airline:
Emergency contact details (preferably someone who is staying in Leeds):
First name:
Surname:
Address:
Postcode:
Relationship to the child:
Contact number: / If the child is not leaving with the parent(s), who is accompanying them?
Who will be caring/responsible for the child?
Why is/are the parent(s) not leaving with the child?
Name:
Relationship to child:
Address:
Postcode:

The Governors of Carr Manor Community School have agreed the following:

• Children must attend school regularly to achieve their potential
• Children who miss out on school can feel vulnerable, left behind and may need to undertake independent study or complete catch-up sessions
• Family requested absence in termtime is very disruptive and can seriously affect a child’s education
• On average, children who miss 17 or more days in a school year, lose one full grade in their GCSEs
• Unauthorised absence can lead to prosecution

The Law

By law, you must ask permission for your child to miss school. If you don’t, you risk a penalty notice of £60 per child per parent if paid within 21 days and £120 if paid between 22 and 28 days. When a school doesn’t give permission, absence is unauthorised and counted as truancy.

Our Policy

Parents do not have the right to remove their child out of school during term time. The Executive Principal will decide whether or not an absence should be authorised. The Executive Principal will only authorise absences in term time when there are exceptional reasons for a child to miss school. A holiday would not be considered exceptional. Requests must be made to the school in advance and cannot be authorised after an absence has been taken.

If an absence has not been authorised by the Executive Principal and parents or carers remove their child from school, their child’s absence will be recorded as unauthorised in the class register.

Pupils who are taken out of school for four weeks or more may be taken off roll resulting in the parent having to re-apply for a place via the Admissions Department of Leeds City Council.

Legal responsibility

Parent’s signature:Parent’s signature:Date:

Parent’s full name:Parent’s full name:Date:

Carr Manor Community School

Exceptional Circumstances Request Form

School Section

Are there any previous requests?
Yes  No  / Is the request absence during exams?
Yes  No 
Reason for refusal/comments:
Authorised  / Approved / For school days
Unauthorised  / Not approved / For school days
Executive Principal’s signature :

Exceptional Circumstances Request FormPage 1 of 3

Jan 2017