Application For Study Leave Template - Christ Our Light
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1APPLICATION FOR STUDY LEAVE
NAME: ________________________________
TUTOR GROUP: __________________________
I wish to apply for the privilege of Study Leave.
Year
11
12
13
I understand that:
Study leave is applicable for session one only. Variations to this must be negotiated with the Deputy
Principal
This application requires the approval of my parent(s)/carer(s), teachers, tutor and Head of House
If required by the College, I must attend school during my Study Leave
If I do not maintain an acceptable standard, permission for Study Leave will be withdrawn
I must sign in at the Campus Office and make myself aware of notices on the daily bulletin upon
arrival, and maintain regular contact with my tutor
If I am present at the College on the morning I have Study Leave I must attend tutor
I am required to uphold the conditions of Study Leave outlined in the accompanying letter
Student Signature: ____________________ Parent Signature: ___________________ Date: _________
Students please indicate in the space provided your requested day, the subjects you are enrolled in and
the names of your teachers. You will need to ask these teachers to recommend you for Study Leave.
Once completed, give this form in person to your Head of House for approval.
Day requesting Session 1 Study Leave
Monday
Tuesday
Wednesday
Thursday
Friday
Teachers: When making your recommendation for Study Leave please consider punctuality, cooperation, completion
of set work and attitude to study. If you have any further concerns, please contact the student’s Head of House.
Recommend
Teacher’s
Line
Subject
Teacher
Comments
Study Leave
Signature
1
Yes No
2
Yes No
3
Yes No
4
Yes No
5
Yes No
Tutor
Yes No
Head of House Comment: ___________________________________________________________________
Head of House Signature: _____________________________________ Date: ________________________
Approved
Not Approved
(return form to office)
Approval letter issued
Head of House meeting with student
(place on student file)
(update leave on SIMON)
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