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MeEroporEan Borougn counctt
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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