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Pupil Appointment Request

Pupil Appointment Request

PUPIL NAME* CLASS*

TYPE OF LEAVE*MEDICAL OR DENTAL APPOINTMENT/PROCEDUREOTHER REQUESTED LEAVE OF ABSENCE (Leave of absences that have not been agreed will be marked as unauthorised absences and may be referred to the authority)

DATES REQUESTED* TIMES REQUESTED* REASON/DESTINATION* COMMENTS Applicable medical letter sent to the office*

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