Current Start Preview Complete Information message Filling out this form will email the relevant department Headteacher details Name Customer name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Contact Contact details Email Phone number Pupil 1 details Name Pupil 1 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Pupil 1 address First line of address Second line of address City/Town Postcode School details School name NCY Child known to Social Care? Yes No Name of allocated social worker Other details Date of birth Language spoken at home Language spoken at home - None -AfrikaansAmharicArabicAsturianAzerbaijaniBelarusianBulgarianBengaliTibetanBosnianCatalanCzechWelshDanishGermanDzongkhaGreekEnglishEsperantoSpanishEstonianBasquePersian, FarsiFinnishFilipinoFaeroeseFrenchFrisian, WesternIrishScots GaelicGalicianSwiss GermanGujaratiHebrewHindiCroatianHaitian CreoleHungarianArmenianIndonesianIcelandicItalianJapaneseJavaneseGeorgianKazakhKhmerKannadaKoreanKurdishKyrgyzLaoLithuanianLatvianMalagasyMacedonianMalayalamMongolianMarathiBahasa MalaysiaBurmeseNepaliDutchNorwegian BokmålNorwegian NynorskOccitanPunjabiPolishPortuguese, PortugalPortuguese, BrazilRomanianRussianScotsNorthern SamiSinhalaSlovakSlovenianAlbanianSerbianSwedishSwahiliTamilTamil, Sri LankaTeluguThaiTurkishTuvanUyghurUkrainianUrduVietnameseLolspeakChinese, SimplifiedChinese, TraditionalOther… Enter other… Add another pupil Pupil 2 details Name Pupil 2 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Pupil 2 address same as pupil 1 address Yes No Pupil 2 address First line of address Second line of address City/Town Postcode School details School name NCY Child known to Social Care? Yes No Name of allocated social worker Other details Date of birth Language spoken at home Language spoken at home - None -AfrikaansAmharicArabicAsturianAzerbaijaniBelarusianBulgarianBengaliTibetanBosnianCatalanCzechWelshDanishGermanDzongkhaGreekEnglishEsperantoSpanishEstonianBasquePersian, FarsiFinnishFilipinoFaeroeseFrenchFrisian, WesternIrishScots GaelicGalicianSwiss GermanGujaratiHebrewHindiCroatianHaitian CreoleHungarianArmenianIndonesianIcelandicItalianJapaneseJavaneseGeorgianKazakhKhmerKannadaKoreanKurdishKyrgyzLaoLithuanianLatvianMalagasyMacedonianMalayalamMongolianMarathiBahasa MalaysiaBurmeseNepaliDutchNorwegian BokmålNorwegian NynorskOccitanPunjabiPolishPortuguese, PortugalPortuguese, BrazilRomanianRussianScotsNorthern SamiSinhalaSlovakSlovenianAlbanianSerbianSwedishSwahiliTamilTamil, Sri LankaTeluguThaiTurkishTuvanUyghurUkrainianUrduVietnameseLolspeakChinese, SimplifiedChinese, TraditionalOther… Enter other… Add another pupil Pupil 3 details Name Pupil 3 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Pupil 3 address same as pupil 1 address Yes No Pupil 3 address First line of address Second line of address City/Town Postcode School details School name NCY Child known to Social Care? Yes No Name of allocated social worker Other details Date of birth Language spoken at home Language spoken at home - None -AfrikaansAmharicArabicAsturianAzerbaijaniBelarusianBulgarianBengaliTibetanBosnianCatalanCzechWelshDanishGermanDzongkhaGreekEnglishEsperantoSpanishEstonianBasquePersian, FarsiFinnishFilipinoFaeroeseFrenchFrisian, WesternIrishScots GaelicGalicianSwiss GermanGujaratiHebrewHindiCroatianHaitian CreoleHungarianArmenianIndonesianIcelandicItalianJapaneseJavaneseGeorgianKazakhKhmerKannadaKoreanKurdishKyrgyzLaoLithuanianLatvianMalagasyMacedonianMalayalamMongolianMarathiBahasa MalaysiaBurmeseNepaliDutchNorwegian BokmålNorwegian NynorskOccitanPunjabiPolishPortuguese, PortugalPortuguese, BrazilRomanianRussianScotsNorthern SamiSinhalaSlovakSlovenianAlbanianSerbianSwedishSwahiliTamilTamil, Sri LankaTeluguThaiTurkishTuvanUyghurUkrainianUrduVietnameseLolspeakChinese, SimplifiedChinese, TraditionalOther… Enter other… Add another pupil Pupil 4 details Name Pupil 4 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Pupil 4 address same as pupil 1 address Yes No Pupil 4 address First line of address Second line of address City/Town Postcode School details School name NCY Child known to Social Care? Yes No Name of allocated social worker Other details Date of birth Language spoken at home Language spoken at home - None -AfrikaansAmharicArabicAsturianAzerbaijaniBelarusianBulgarianBengaliTibetanBosnianCatalanCzechWelshDanishGermanDzongkhaGreekEnglishEsperantoSpanishEstonianBasquePersian, FarsiFinnishFilipinoFaeroeseFrenchFrisian, WesternIrishScots GaelicGalicianSwiss GermanGujaratiHebrewHindiCroatianHaitian CreoleHungarianArmenianIndonesianIcelandicItalianJapaneseJavaneseGeorgianKazakhKhmerKannadaKoreanKurdishKyrgyzLaoLithuanianLatvianMalagasyMacedonianMalayalamMongolianMarathiBahasa MalaysiaBurmeseNepaliDutchNorwegian BokmålNorwegian NynorskOccitanPunjabiPolishPortuguese, PortugalPortuguese, BrazilRomanianRussianScotsNorthern SamiSinhalaSlovakSlovenianAlbanianSerbianSwedishSwahiliTamilTamil, Sri LankaTeluguThaiTurkishTuvanUyghurUkrainianUrduVietnameseLolspeakChinese, SimplifiedChinese, TraditionalOther… Enter other… Parent/Carer 1 details Name Parent/Carer 1 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Parent/Carer 1 address same as pupil 1 address Yes No Parent/Carer 1 address First line of address Second line of address City/Town Postcode Contact Contact details Phone number Other details Date of birth Add second parent/carer Parent/Carer 2 details Name Parent/Carer 2 name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Parent/Carer 2 address same as pupil 1 address Yes No Parent/Carer 2 address First line of address Second line of address City/Town Postcode Contact Contact details Phone number Other details Date of birth Information about this leave of absence Was permission for this absence requested in advance from parent/carers? Yes No Was permission given? Yes No Dates of unauthorised absence from Dates of unauthorised absence to Number of school days Minimum of 5 consecutive days Additional comments Documents Copy of the request for leave of absence (if applicable)? Copy of the letter to the parent/carers advising them that the leave was not authorised? Copy of the child/children’s attendance certificate showing G codes? 20307
