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Directorate for Children, Young people and Families
Holiday Request Form I wish to apply for my child to take a holiday during term time. I understand that this will result in work being missed and will make every effort to ensure that it is copied upon return.
Holiday dates Start date: ....1....1.... End date: ....1....t...,
Number of schoot days
missed
f]
Reason for requesting a holiday at this time
* LETTER FROM EMPLOYER IF DUE TO WORK COMMITMENTS MUST BE ATTACHED TO THIS REQUEST FORM
Full name and address of parent applying for holiday leave:
Full name and address of parent taking child on holiday (if different):
Name of child(ren) [include siblings at other Barnsley MBC Schoolsl
Signed
...
Parent/Carer
Form/Name of School
Date of application
If you go ahead with the holiday when unauthorised, you will incur a Fixed Penalty Notice issqed through the Local Authority. Per child, this will be f 50 if paid wiihin 28 days; t100 if paid betwee n zg- qz days.SER/EWAS/SIandard/Application for absence
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Directorate for Children, young people and Families
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Holiday Request Reply Permission to take a hotiday is granted
l-l
(subject to overatt attendance remaining above
.
.%)
Permission to take a holiday is NOT granted Reason(s) for permission not being granted: No letter from employer/no acceptable reason given why holiday taken in term time
First half term of Academic year
y9
SATS preparation: Y2 Y6 (between January and May half terms) Year 11 (GCSE)
tr
Attendance is less than national average (Sept to date of application)
f
Previous holiday taken in academic year
tl
lnternal exams /assessments near or during time of proposed assessment
u
Date of Reply:
S
ER/EWAS/SIa ndard/App lication for absence
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