Holiday/Extended Leave Request Form

Application for Leave of Absence – Penwortham Girls’ High School

Please ensure you have read the attached guidance before requesting a leave of absence.

Please note: There is no entitlement to a leave of absence. A leave of absence will only be granted in exceptional circumstances.

An unauthorised leave of absence could result in each of the pupil's parents/guardians being issued with a fixed penalty fine.

Name of Student
I wish to apply for a leave of absence from school:
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
In the event that the above named child isn't resident with both parents, signatures from both parents are required.
Address

Office use:

Authorised: Y / N

Reason:

 

Date:

Consent
This field is for validation purposes and should be left unchanged.
  • Arts Council England - Artsmark Gold
  • Lancashire Socio-economic Equality Badge
  • SMART
  • UNICEF
  • School Mental Health Award
  • Ofsted - Outstanding Provider
  • Arts Council England - Artsmark Gold
  • Lancashire Socio-economic Equality Badge
  • SMART
  • UNICEF
  • School Mental Health Award
  • Ofsted - Outstanding Provider