Staff - Exclusion Request

Exclusion Request (Internal and External)
This form should only be used by a member of SLT or a Head of School to generate an internal or external exclusion. Thank you.
Student *

First Name Last Name
Form *
Staff Name *

First Name Last Name
Your email address *
Your email address *
example@example.com
Reason (Letter Text) *
Enter the reason for this exclusion, this will be the text that shows in the letter that is sent home and the reason the parent sees on G4S
Coded Reason *
This is a default field that is required on Bromcom
School Notes *
Enter a description as to why they are being excluded, this will be the text that goes into the School Notes field on G4S. Parents will NOT see this information
Exclusion type *

Internal exclusion (ALE entry only) External exclusion (out of school) Permanent Exclusion
Duration *

Half day 1 day 2 days 3 days 4 days 5 days Internal Exclusion Pending Perm Permanent
Start Date of Exclusion *

Day Month Year
Date
End Date of Exclusion

Day Month Year
Date
Detention start time

AM PM
Reintegration Meeting Date and Time (if applicable)

Day Month Year
Date Hour Minutes
Staff undertaking meeting
First Day Back Arrangements
If the reintegration meeting is not set for the student's first day back following the exclusion, please explain the arrangements for the student on their return (for the letter)
Please confirm whether or not this exclusion request has been approved by the Headteacher
Headteacher Approval *

Yes No
Comments
Enter alternative text to place in the letter if you do not intend carrying out a reintegration meeting or enter details of phone call made home if applicable.
The John Warner School, Stanstead Road, Hoddesdon EN11 0QF.
www.johnwarner.herts.sch.uk T: 01992 462889 F: 01992 470679
Should be Empty:

Exclusion Request (Internal and External)