Leave of Absence Form (Years 7-13)

Please complete this form for any advanced requests for a leave of absence from school for your son/daughter.

This form should not be used for ‘on the day’ emergency medical appointments etc. All your son/daughter will need for this is a note from home, which they can show in to the main school office, when they sign out to leave school, upon collection.

Student Details*
Name Of Student (s) Year Group (e.g. Year 8) Form Group (e.g. 9.2)
First date of absence*
DD slash MM slash YYYY
Last date of absence*
DD slash MM slash YYYY
Total days absence*
Reason for absence (please be specific)*
Email address of parent*

The Coopers’ Company & Coborn School

St. Marys Ln,
Upminster,
RM14 3HS

01708 250500
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The Coopers’ Company and Coborn School is a company limited by guarantee, and an exempt charity, registered in England and Wales under company number 07547060. The registered address is: St Mary’s Lane, Upminster, Essex. RM14 3HS

Name Of Student (s)	Year Group (e.g. Year 8)	Form Group (e.g. 9.2)