St Anselm's Catholic Primary School

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Request for Absence

Please complete this form if you would like to request that your child is absent from school

Name of pupil

Class

Reason for absence

Date of absence

Time of absence (start)

Time of absence (return)

Number of days

Will your child have a school dinner on this day?

Is this a medical appointment? If so, please submit evidence via email, or bring to the school office

(For office use only) Authorised by the headteacher? Yes No

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St Anselm's Catholic Primary School

Request for Absence

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