WORCESTER SIXTH FORM COLLEGE FINANCIAL SUPPORT FOR STUDENTS POLICY

WORCESTER SIXTH FORM COLLEGE FINANCIAL SUPPORT FOR STUDENTS POLICY JULY 2013

CONTENTS 1. Introduction 2. Aims 3. Principles for Allocation 4. Process 5. Guidelines 6. Monitoring 7. Appendices

1. Introduction The College receives an annual allocation of Discretionary Learner Support from the Education Funding Agency (EFA), 16-19 year olds and the Skills Funding Agency (SFA) for 19+ categories respectively. The size of the allocation is determined by the number of students on the College s roll. The College refers to this source of financial support as its Student Support Fund. The fund is subject to internal audit. 2. Aim The College intends to dispense its Student Support Fund to provide financial assistance to students who otherwise might be inhibited from participating in a College course for financial reasons. 3. Principles for Allocation To be eligible for financial assistance from the Student Support Fund a student must be: (i) (ii) (iii) enrolled as a student at the College aged 16 or over on 31st August prior to the start the course ordinarily resident in the United Kingdom for the last three years (and not to have come to the UK for the purpose of being a full time student) 4. Process Students 16-19 are invited to apply for one or more of the following forms of financial assistance: (i) Education Bursary (ii) Education Allowance (iii) Travel Allowance (Severn Card) (iv) The Additional Student Support Fund (See Appendix 4) Students 19+ are invited to apply under one or more of the following categories of financial assistance (see Appendix 2): (i) (ii) (iii) Travel Allowance Child care costs Ex-military personnel Any funds available for allocation will be paid half-termly, dependent upon attendance. Students 24+ who are in receipt of an Advanced 24+ Learning Loan (from Student Loans Company) may also apply under one or more of the following categories of financial assistance (see Appendix 3): (i) (ii) (iii) Travel Allowance Child care costs Ex-military personnel Any funds available for allocation will be paid half-termly, dependent upon attendance. The fund is administered by a Student Support Fund Committee which meets at the beginning of each term. Membership of this Committee consists of: Assistant Principal (Students) Adult & Community Education Co-ordinator Finance Officer Student Support Fund Committee Secretary

(i) (ii) (iii) (iv) The Assistant Principal (Students) may make discretionary decisions to allocate funds if a need is urgent. Each application is judged on its merits and those students who are most in need of help are identified. The Student Support funds are limited and consequently it may not be possible to respond positively to all applications. Applicants are notified of the outcome of their application within three weeks of the published closing dates for applications (see section 5 below). The College uses its Student Support Fund to continue to provide financial support for 16-19 students who previously benefited from the County s schools scheme to provide a subsidy for the purchase of a daytime meal. Applications from families that had not previously applied to that scheme are considered initially by a member of the Finance team before being passed to a Head of Year/ the Adult & Community Education Co-ordinator and if supported by them, the decision to award is finally made by the Assistant Principal (Students). 5. Guidelines Awards are made on the basis given below: (i) (ii) (iii) Education Bursary A Bursary of 1,200 a year for students in care, care leavers, students who receive Income Support in their own right or those in receipt of Employment Support Allowance and Disability Living Allowance. (See Appendix 1) Education Allowance An Education Allowance of 350 a year for students whose household income is below 16,190. Travel Allowance (Severn Card) equating to ⅔ of the cost of the Severn Card. A Travel Allowance for students whose household income is below 30,810 a year and who live more than three miles from College and who have purchased a Severn Card. Awards from the Additional Student Support Fund and made by the Student Support Fund Committee (see Appendix 4) are based upon the principle that the families of eligible applicants are likely to be in receipt of either: Working tax credit Income support/universal credit 6. Decision Guidelines In addition, however, the following guidelines will advise those making decisions: (i) (ii) (iii) (iv) (v) (vi) Applicants/Parents of applicants in receipt of welfare benefits will be required to show proof of benefit payment. Applicants/Parents of applicants must be prepared to show evidence of income and living expenses. Applications from 16-19 students living independently may be considered. Applications for travel assistance from 16-19 students would not normally be considered if they live less than three miles from College. Applications for travel assistance from 19+ students if successful would normally fund the cheapest method of travel. Car travel may be funded as the methodology outlined in Appendix 6. Applications for support for trips/visits/exchanges from eligible students will be judged on the following basis: (a) Trips essential to the course will be fully funded; (b) Trips not essential to the course may receive a maximum of 50% support

(vii) (viii) (ix) (x) (xi) (xii) (xiii) (xiv) An application from a student whose attendance is or falls below 95% (agreed at the discretion of the Student Support Fund Committee may not qualify for full support). 19+ students who have successfully applied to the Student Support Fund for assistance with travel costs but whose attendance has been broken by long periods of continuous absence may as a consequence receive only a reduced portion of their allocation. Applications for support for the cost of peripatetic music lessons from eligible students where lessons are not essential for a course being studied may receive a maximum of 50% support. The Student Support Fund team will monitor the total value of awards made to individual students from The Additional Student Support Fund and normally restrict the total to 300. A student who has received an allocation from the Student Support Fund and leaves before the completion of their course may be required to repay all or part of their allocation. Any appeal against a decision made by the Student Support Fund Committee should be made in writing to the Deputy Principal. This decision is final. Any complaints relating to Financial Support will be dealt with by the College according to its Complaints Policy, which is available upon request. For the methodology for assessing payments due to 19+ students, please see Appendix 6. 7. Monitoring This policy is monitored annually by the Senior Management Team. The funding allocation to the College and its disbursement is subject to annual checks made by the funding bodies and the College s Auditors. The application forms referred to in appendices 1, 2 and 3 are adapted as required. 8. Appendices (i) (ii) (iii) Application for College Financial Support Funds 16-19 students Application for Student Support Funds 19+ students Education Bursary Leaflet

APPENDIX 1 Application for College Financial Support for Students Academic Year 2013/14 FSF13/14 Please complete this form in BLACK INK and in BLOCK CAPAITALS and take to the Student Records office with supporting original financial evidence. Forms will be accepted from 27 th August up to 1 st October 2013. Please answer all of the questions enter N/A or No where appropriate. Make sure you sign and date the application on the last page. Section 1 Which scheme are you applying for? 1.1 Education Bursary A Bursary of 1,200 a year for students in care, care leavers, students who receive Income Support/Universal Credit in their own right or those in receipt of Employment Support Allowance and Disability Living Allowance. Yes Choose one of the below: I am in Care/classed as Looked After Child by the Local Authority I am in receipt of Employment Support Allowance and Disability Living Allowance I have been in Care and am now classed as a Care Leaver I am formally estranged from my parents and receive Income Support/Universal Credit for this reason No Go to section 1.2 OFFICE USE ONLY Evidence Seen 1.2 Education Allowance An Education Allowance of 350 a year for students whose household income is below 16,190. Yes Evidence required: Tax award notice (TC602) - Go to section 1.3 OFFICE USE ONLY TC602 No Go to section 1.3 1.3 Travel Allowance (Severn Card) Higher Rate A Travel Allowance (2/3 of the cost of the Severn Card) a year for students whose household income is below 30,810 a year and who live more than 3 miles from College and have purchased a Severn Card. Yes - Evidence Required: Tax award notice (TC602) Severn Card - Go to section 2 No - Go to section 2 TC602 OFFICE USE ONLY Severn Card (Annual) Severn Card (Term) OFFICE USE ONLY Reference Checked By Scanned By

Section 2 Your Personal Details Your student number (on your ID card) S Leave blank if unknown/not issued Your title (tick one box only) Mr Mrs Miss Ms Other Your first names (in full) Your surname (in full) Your date of birth Your age (in years) on 31 August 2013 Your home address Your term time address (if different from home address) Please state your nationality Have you always lived in the UK? Yes No If No, where have you lived? From To DD/MM/YY DD/MM/YY Section 3 About the other people living in your home Parent(s) / guardian(s) you live with Surname First Name Date of birth N/A Section 4 Your Payment Details - Complete ALL the boxes below. - If we can pay support directly to you we will do this by paying the money directly into your bank account - Make sure your account can accept BACS Direct Credits. You can check this with you bank (we cannot pay into Post Office Accounts) Bank Name (e.g. HSBC) Branch Location (e.g. Worcester Broad St) Name of Account Holder (e.g. Mr J Bloggs) Sort Code Account Number

Section 5 Declaration By signing in the box below: YOU UNDERSTAND THAT: If you leave before the end of term any travel allowance will not be paid The relevant attendance criteria must be met before we can make a payment YOU CONFIRM THAT: The information you have given on this form is to the best of your knowledge correct and true YOU AGREE THAT: Worcester Sixth Form College can process your personal data contained in this form and on your Student Learning Agreement in order to assess your eligibility for the Financial Support Fund. If you have given personal information relating to anyone else on this form you have obtained their permission to disclose it. Sign your name in this box Write (in BLOCK CAPITALS) your name in this box Write today s date in this box When you have completed this form you should take it (with all the financial evidence required) to the Student Records office at the College Confidentiality: Applications are only seen by staff involved in the delivery of College Financial Support Fund. From time to time it may be necessary for additional supporting information to be sought from other College staff in order for a decision to be made. Data Protection Act 1998: Worcester Sixth Form College is a data controller in terms of the 1998 legislation. Staff follow College Policies in matters of Data Protection. The data requested on this form and any other supporting information is covered under the notification provided by the College under the Data Protection Act. Personal Data will be used solely for the purposes related to your application for financial support. The data you provide will not be passed to any other third party without your prior consent, except where the College is required to do so by law. Any formal enquiries concerning the use of data noted here should be addressed to the Data Protection Officer. If you need any further information or help with making an application, please contact us: Telephone (01905) 362611 Email us: fs.fund@wsfc.ac.uk visit our website: www.wsfc.ac.uk

APPENDIX 2 Application for College Financial Support for Adult Student Academic Year 2013/14 FSF13/14 Please complete this form in BLACK INK and in BLOCK CAPAITALS and take to the Finance office with all the required evidence after 2 nd September 2013 (forms will only be processed with all the necessary evidence provided). Answer all of the questions required enter N/A or No where appropriate. Make sure you sign and date the application on the last page. Section 1 Which scheme are you applying for? 1.1 Financial Support for Adults Yes Evidence Required: Tax Award Notice (TC602) Evidence of Income Support or Benefits P60 If working - Go to Section 1.3 No Go to section 1.2 OFFICE USE ONLY Evidence Seen 1.2 Travel Support for Adults Yes Evidence Required: Tax Award Notice (TC602) Evidence of Income Support or Benefits P60 If working - Go to Section 1.3 No Go to section 1.3 OFFICE USE ONLY Evidence Seen 1.3 Child Care Yes - Evidence Required: Tax award notice (TC602) Evidence of Income Support or Benefits P60 If working Ofsted Registered Childcare Provider Registration No. - Go to section 2 No - Go to section 2 OFFICE USE ONLY Evidence Seen Received By OFFICE USE ONLY Scanned By Checked By

Section 2 Your Personal Details Your student number (on your ID card) S Leave blank if unknown/not issued Your title (tick one box only) Mr Mrs Miss Ms Other Your first names (in full) Your surname (in full) Your date of birth Your age (in years) on 31 August 2013 Your National Insurance no. Your home address Your term time address (if different from home address) I am receipt of income support I am an ex-member of the Armed Services (Please provide evidence) (Please provide evidence) Section 3 About the other people living in your home Surname First Name Date of birth N/A Section 4 Your Payment Details - Complete ALL the boxes below. - If we can pay support directly to you we will do this by paying the money directly into your bank account or someone else s account with your permission - Make sure your account can accept BACS Direct Credits. You can check this with you bank (we cannot pay into Post Office Accounts) Bank Name (e.g. HSBC) Branch Location (e.g. Worcester Broad St) Name of Account Holder (e.g. Mr J Bloggs) Sort Code Account Number

Section 5 Declaration By signing in the box below: YOU UNDERSTAND THAT: If you leave before the end of term any travel allowance will not be paid The relevant attendance criteria must be met before we can make a payment YOU CONFIRM THAT: The information you have given on this form is to the best of your knowledge correct and true YOU AGREE THAT: Worcester Sixth Form College can process your personal data contained in this form and on your Student Learning Agreement in order to assess your eligibility for the Financial Support Fund. If you have given personal information relating to anyone else on this form you have obtained their permission to disclose it. Sign your name in this box Write (in BLOCK CAPITALS) your name in this box Write today s date in this box When you have completed this form you should take it (with all the evidence required) to the Finance department at the College Confidentiality: Applications are only seen by staff involved in the delivery of College Financial Support Fund. From time to time it may be necessary for additional supporting information to be sought from other College staff in order for a decision to be made. Data Protection Act 1998: Worcester Sixth Form College is a data controller in terms of the 1998 legislation. Staff follow College Policies in matters of Data Protection. The data requested on this form and any other supporting information is covered under the notification provided by the College under the Data Protection Act. Personal Data will be used solely for the purposes related to your application for financial support. The data you provide will not be passed to any other third party without your prior consent, except where the College is required to do so by law. Any formal enquiries concerning the use of data noted here should be addressed to the Data Protection Officer. If you need any further information or help with making an application, please contact us: Telephone (01905) 362600 Email us: fs.fund@wsfc.ac.uk visit our website: www.wsfc.ac.uk

APPENDIX 3 Application for College Financial Support for Students in Receipt of an Advanced 24+ Learning Loan Academic Year 2013/14 FSF13/14 Please complete this form in BLACK INK and in BLOCK CAPAITALS and take to the Finance office with all the required evidence after 2 nd September 2013 (forms will only be processed with all the necessary evidence provided). Answer all of the questions required enter N/A or No where appropriate. Make sure you sign and date the application on the last page. Section 1 Support for Students in Receipt of an Advanced 24+ Learning Loan 1.1 Are you in Receipt of an Advanced 24+ Learning Loan? Yes - Go to Section 1.2 No Please fill in the Adult Financial Support Form 1.2 Support towards Travel OFFICE USE ONLY Evidence Seen Yes Evidence Required: Tax Award Notice (TC602) Evidence of Income Support or Benefits P60 If working - Go to Section 1.3 No Go to section 1.3 OFFICE USE ONLY Evidence Seen 1.3 Support towards Child Care Yes - Evidence Required: Tax Award Notice (TC602) Evidence of Income Support or Benefits P60 If working Ofsted Registered Childcare Provider Registration No. Invoice/Receipt from Provider - Go to section 2 No - Go to section 2 OFFICE USE ONLY Evidence Seen Received By OFFICE USE ONLY Scanned By Checked By

Section 2 Your Personal Details Your student number (on your ID card) S Leave blank if unknown/not issued Your title (tick one box only) Mr Mrs Miss Ms Other Your first names (in full) Your surname (in full) Your date of birth Your age (in years) on 31 August 2013 Your National Insurance no. Your home address Your term time address (if different from home address) I am receipt of income support/universal credit I am an ex-member of the Armed Services (Please provide evidence) (Please provide evidence) Section 3 About the other people living in your home Surname First Name Date of birth N/A Section 4 Your Payment Details - Complete ALL the boxes below. - If we can pay support directly to you we will do this by paying the money directly into your bank account or someone else s account with your permission - Make sure your account can accept BACS Direct Credits. You can check this with you bank (we cannot pay into Post Office Accounts) Bank Name (e.g. HSBC) Branch Location (e.g. Worcester Broad St) Name of Account Holder (e.g. Mr J Bloggs) Sort Code Account Number

Section 5 Declaration By signing in the box below: YOU UNDERSTAND THAT: If you leave before the end of term any travel allowance will not be paid The relevant attendance criteria must be met before we can make a payment YOU CONFIRM THAT: The information you have given on this form is to the best of your knowledge correct and true YOU AGREE THAT: Worcester Sixth Form College can process your personal data contained in this form and on your Student Learning Agreement in order to assess your eligibility for the Financial Support Fund. If you have given personal information relating to anyone else on this form you have obtained their permission to disclose it. Sign your name in this box Write (in BLOCK CAPITALS) your name in this box Write today s date in this box When you have completed this form you should take it (with all the evidence required) to the Finance department at the College Confidentiality: Applications are only seen by staff involved in the delivery of College Financial Support Fund. From time to time it may be necessary for additional supporting information to be sought from other College staff in order for a decision to be made. Data Protection Act 1998: Worcester Sixth Form College is a data controller in terms of the 1998 legislation. Staff follow College Policies in matters of Data Protection. The data requested on this form and any other supporting information is covered under the notification provided by the College under the Data Protection Act. Personal Data will be used solely for the purposes related to your application for financial support. The data you provide will not be passed to any other third party without your prior consent, except where the College is required to do so by law. Any formal enquiries concerning the use of data noted here should be addressed to the Data Protection Officer. If you need any further information or help with making an application, please contact us: Telephone (01905) 362600 Email us: fs.fund@wsfc.ac.uk visit our website: www.wsfc.ac.uk

APPENDIX 4 Student Name... Student Number. D.O.B. Section 1 Are you eligible? Application for Additional Student Support 16-18 1.1 Are you in receipt of an Education Bursary or Education Allowance? Yes Please provide evidence of household income being below 16190 then Go to Section 2 No Go to Section 1.2 1.2 Current Circumstances. Is your family household income below 16,190? Yes Please complete the College Financial Support for Students Form, then complete this form and provide evidence. No Go to Section 1.4 1.3 Exceptional Circumstances Has any changes taken place to your family situation since you started at college? Yes Please give details No Go to Section 1.4 1.4 Unfortunately you do not qualify for student support. If you are in difficult financial circumstances please discuss with your head of year. Section 2 Details of Support Needed. Please give details of what support you require Trips Exam Entry Materials/Equipment Other

Student Name... Student Number. Section 3 - DECLARATION: D.O.B. I declare that all the information I have given is correct and complete to the best of my knowledge. I understand that this information may be verified and I agree to abide by the terms and conditions set by the Student Support Team. I recognise that false statements can leave me open to prosecution. Signed: Date:... Print Name. PLEASE TAKE THIS FORM TO STUDENT RECEPTION FOR CHECKING BEFORE DISCUSSING WITH YOUR HEAD OF YEAR Section 4 For completion by Student Reception Application Form checked and Supported: Signed.. Date. For Completion by Head of Year Application Receipt Date: Comments:.. Attendance (please express as a percentage). Application Recommended : Yes No Signed Date:..

APPENDIX 5 FINANCIAL SUPPORT SCHEME FINANCIAL SUPPORT FOR STUDENTS Depending upon household income, personal circumstances, and travel arrangements, students at Worcester Sixth Form College can apply to the College s Financial Support Scheme for one of the following: A Bursary of 1,200 a year for students in care, care leavers, students who receive Income Support (or universal credit) in their own right or those in receipt of both Employment Support Allowance and Disability Living Allowance. An Education Allowance of 350 a year for students whose household income is below 16,190. A Travel Allowance (equating to 2/3 of the cost of the Severn Card) for students whose household income is below 30,810 a year, who live more than 3 miles from College and have purchased a Severn Card. For students aged 19 or over on 31st August 2013 there is a separate scheme to provide financial support for Adult Students. You will need to show that you satisfy the relevant income criteria. The evidence required by the College is proof of the previous year s household income via a Tax Credit Award Notice (Form-TC602) or evidence of self-employment income. Other evidence, usually in the form of benefits letters, may be accepted at the discretion of the Assistant Principal (Student Support and Progression). An application form for the 2013/14 academic year is now available to download from our website. The College Financial Support Fund is paid on condition that students attend 100% of their lessons in any qualifying week. The Bursary and Education Allowance are paid weekly in arrears and the Travel Allowance is paid termly in arrears. Education and Travel Allowances are paid over two terms; no payments are made in the Summer Term Important notes/information to remember in respect of payment and conditions for the above payments Students will be responsible for monitoring their attendance record and for checking it regularly via the gateway each week. If students have unmarked registers it is their responsibility to contact their subject teacher to amend the records appropriately. If this is the case, and a register is subsequently marked and attendance is sufficient to qualify, students will receive the payment in the following week. If students feel the need for assistance in following up registers that are not marked regularly, please discuss with a member of staff in the Student Records Office(SRO).

To check attendance through the WSFC gateway, students click on my timetable and will be able to see any absences or unmarked registers throughout the week. It is very important that the time is taken each week to check on the accuracy of the attendance record, as this is the data used to facilitate payments, whether weekly or termly. Further information on the principles and procedures application are available in the WSFC Financial Support for Students policy available on request. The following reasons may result in your absence being authorised, providing you apply in advance. The only evidence we will accept is: Medical Appointments which cannot be arranged outside College hours Evidence: Appointment card/appointment letter, hospital letterhead Official University/College/Employer interview or visit Evidence: letter from parent/guardian/official letter from university, college or employer Work Experience placement/trip (not organised by the College) If your work experience/trip is organised by the College this absence will automatically be authorised on receipt of your orange/purple card in SRO. Evidence: official letter from placement organisers and planned absence form Participation in a significant extra-curricular event, e.g. representing UK at a sporting Event Evidence: official correspondence from event organisers Driving Test not Theory Test: Evidence: print-out of driving test booked time Official religious observance: Evidence: letter from parent/guardian Other events at the discretion of the Assistant Principal (Student Support and Progression) Evidence: as specifically requested by the Assistant Principal (Student Support and Progression For all of the above completion of the Authorised Absence Request form, available on line or from SRO, is required. This should be completed prior to your absence. THE ADDITIONAL STUDENT SUPPORT FUND FOR 16-18 AND 19+ STUDENTS If your household income is below 16,190 you can apply for financial support from the College to help meet the costs of the following: The cost of buying resources which are required to study a particular course e.g. textbooks, art resources, specialist equipment or clothing. A meal subsidy of up to 2 per day on meals purchased in the College Cafeteria. Work Experience charges.

College trips. For trips considered essential or compulsory to the course the award will be for the entire cost of the trip, up to a maximum of 300. For nonessential trips the award will be for 50% of the cost of the trip, up to a maximum of 300. The total amount awarded for trips of any description not to exceed 300 per person per year. Emergency living expenses, e.g. those associated with sudden homelessness. Emergency travel expenses. If you travel more than 1 mile (no limit if you have a disability which affects your mobility) to College by public transport you can apply for financial support of up to 7 per week on provision of evidence in the form of travel passes or tickets. In exceptional circumstances the Assistant Principal (Student Support and Progression) can consider making a loan payment. 19+ students. You can apply for financial support from the Discretionary Student Support Fund to cover travel costs associated with private transport. If you are over 19 and live more than 1 mile (no limit if you have a disability which affects your mobility) from the College then you can qualify for a mileage allowance of up to 20 pence per mile. 19+ students. You can apply for financial support to assist with child care costs. If you are the parent/guardian of (a) child(ren) in receipt of paid for child care with an Ofsted registered child minder you may qualify for financial support. The College will pay those child care costs directly associated with attending College courses up to a limit of 70 per week. In all the above cases you will need to show that your household income is below 16,190. The evidence required by the College is proof of the previous year s household income via a Tax Credit Award Notice (Form-TC602). Other evidence, usually in the form of benefits letters, may be accepted at the discretion of the Assistant Principal (Student Support and Progression). To qualify for financial support from the Additional Student Support Fund you will need to maintain an official College attendance of 90% or above. If you think you would qualify for any of the support listed above you should seek advice from your Head of Year, Julie Ferman or Graham Williams, or from the Assistant Principal (Student Support and Progression), Ian Birth. You should then pick up the appropriate form from Student Reception.

Authorised Absence Request Form SScc Student applies with evidence to SRO SRO reviews accepts/ authorises where appropriate Exceptions referred to Head of Year Please complete the form below to apply for an authorised absence, together with the necessary evidence to support your application and hand in to a member of staff in SRO. SRO will either reject or authorise the absence and will refer you to your Head of Year for any requests that require further discussion. If your trip/visit/activity is organised by the College, your absence will automatically be authorised. The following reasons may result in your absence being authorised, providing you apply in advance. The only evidence we will accept is: Medical Appointments which cannot be arranged outside College hours Evidence: Appointment card/appointment letter, hospital letterhead Official University/College/Employer interview or visit Evidence: letter from parent/guardian/official letter from university, college or employer Work Experience placement/trip (not organised by the College) If your work experience/trip is organised by the College this absence will automatically be authorised. Evidence: official letter from placement organisers Participation in a significant extra-curricular event, e.g. representing UK at a sporting event Evidence: official correspondence from event organisers Driving Test not Theory Test: Evidence: print-out of driving test booked time Official religious observance: Evidence: letter from parent/guardian Other events at the discretion of the Assistant Principal (Student Support and Progression) Evidence: as specifically requested by the Assistant Principal (Student Support and Progression). Authorised Absence Request Form Name of student:... Tutor Group... Date of absence:... Time of absence, please circle one only: Morning Afternoon Full Day Reason for absence:------------------------------------------------------------------------------------------------------------------------------------------ Signature:----------------------------------------------------------- --------------- Date:---------------------------------------- For office use only SRO approved/evidence seen Signature ------------------------------------------------- Date------------------------------------ Absence authorised Where applicable Head of Year authorisation Yes/No (please circle) Yes/No (please circle) Signature-------------------------------------------------------------------- Date ------------------------------------