Request for Gap in Study Form

This form should be completed by parents/guardians who wish to request a study break for their child. As per Edurium’s policy, parents may request a gap in study of at least one month. During this break, no tuition fees will be charged for the period of absence, provided the form is submitted in advance.

Request for Gap in Study Form

Student Information

Full Name of Student

Current Year Group

3456

Preferred Centre

WhittonTwickenham

Subjects Currently Studying

Study Gap Request Details

Requested Start Date of Study Gap

MM slash DD slash YYYY

Requested End Date of Study Gap

MM slash DD slash YYYY

Reason for Study Gap

Consent

I confirm that the above information is correct. I understand that tuition fees will not be charged for the approved period of study gap, and that tuition will resume immediately after the agreed end date.

Parent/Guardian Signature

Date

MM slash DD slash YYYY